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ST Segment Resolution After Fibrinolysis for STEMI

TIMI ECG Core Laboratory. ST Segment Resolution After Fibrinolysis for STEMI. 180 minutes. Calculating ST Resolution Anterior MI Sum (ST elev in V1-V6,I,aVL) + Sum (ST dep in II, III, aVF) Inferior MI Sum (ST elev in II, III, aVF) + Sum (ST dep in V1-V4) ST Resolution Sum STdev at f/u

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ST Segment Resolution After Fibrinolysis for STEMI

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  1. TIMI ECG Core Laboratory ST Segment Resolution After Fibrinolysis for STEMI 180 minutes Calculating ST Resolution Anterior MI Sum (ST elev in V1-V6,I,aVL) + Sum (ST dep in II, III, aVF) Inferior MI Sum (ST elev in II, III, aVF) + Sum (ST dep in V1-V4) ST Resolution Sum STdev at f/u Sum ST dev at 180m Baseline Reperfusion vs x 100% 100%- No Reperfusion This presentation reflects the views of the presenter and does not necessarily reflect the views of the American College of Cardiology . Content Distributed by Cardiosource. de Lemos et al, AJC 2000; Schroder et al, Lancet 2001

  2. STRes Category None Partial Complete ST Resolution at 180 min according to treatment strategy UFH n=1137 ENOX n=1167 P=NS Similar baseline characteristics and concomitant therapy in ENOX and UFH groups Scirica et al. AHA 2006

  3. Adj OR 1.2 p=0.47 Adj OR 0.41 p<0.001 Adj OR 1.03 p=0.92 p for interaction=0.004 16.2% 15.9% 14.2% 12.5% 9.9% 4.4% 575 525 422 408 N= 167 201 Complete (>70%) Partial (30-70%) None (<30%) 30 day Death / MI according STRes and treatment 30 day Death / MI Scirica et al. AHA 2006

  4. Recurrent MI in patients With Complete STRes 8 UFH (n=525) 6 48 hours Recurrent Nonfatal MI (%) 4 P=.0021 Enoxaparin (n=575) 2 0 0 5 10 15 20 25 30 UFH Days From Randomization ENOX Median treatment duration Scirica et al. AHA 2006

  5. Conclusions • ENOX does not appear to facilitate early reperfusion as determined by STRes • ENOX is associated with a significant reduction in death/MI in patients who achieved early STRes • Thus ENOX appears to improve clinical outcomes by preventing re-occlusion rather than by facilitating early reperfusion.

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