Comparison of TIMI Flow in STEMI Patients With and Without Resolution on Reciprocal ST Segment Depression Obtaining Fibrinolytic Alteplase Therapy

https://doi.org/10.22146/aci.50220

Aldino Satria Adhitya(1*), Harris Hasan(2), Refli Hasan(3), A. Afif Siregar(4), Zulfikri Mukhtar(5), Ali Nafiah Nasution(6)

(1) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(2) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(3) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(4) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(5) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(6) Department of Cardiology and Vascular Medicine, Faculty of Medicine, Universitas Sumatera Utara - Adam Malik Hospital, Medan, North Sumatera
(*) Corresponding Author

Abstract


Background: STEMI patients need revascularization to improve blood flow and myocardial reperfusion. Further information can be obtained from the ECG including infarct size and prognosis of STEMI patients. ST segment depression (STSD) in reciprocal leads is
associated with poorer prognosis. STEMI patients with STSD resolution have a better TIMI flow compared with no STSD resolution. The aim of this study was to look for TIMI flow for STEMI subjects who received fibrinolytic therapy with and without resolution of STSD shortly after fibrinolytic.

Methods: This study is a prospective cohort study, in which 60 STEMI subjects, patients performed coronary angiography diagnostics to assess TIMI flow. The resolution on reciprocal STSD is defined as a decrease of 50% in the amount of reciprocal STSD in 90- minute after fibrinolytic therapy started.

Results: Bivariate analysis showed that ejection fraction <40% with p = <0.001; QRS duration, p = <0.001; anterior STEMI with p = <0.001; are significant factors for STSD resolution. QRS Fragmentation with p = <0.001; STSD resolution with p = <0.001; ST elevation resolution with p = <0.001; are significant factors for TIMI Flow. In the TIMI Flow comparison with reciprocal STSD resolution; the resolution of reciprocal STSD has a better TIMI flow with OR 28 [(5.5-141.9), p = <0.001].

Conclusion: There were differences in TIMI Flow in STEMI patients with reciprocal STSD resolution and without reciprocal STSD resolution who received fibrinolytic alteplase therapy, where STEMI patients with reciprocal STSD resolution had a better TIMI Flow compared with STEMI patients without reciprocal STSD resolution.


Keywords


resolution; reciprocal ST segment depression; TIMI flow; STEMI; fibrinolytic

Full Text:

PDF



DOI: https://doi.org/10.22146/aci.50220

Article Metrics

Abstract views : 83 | views : 146

Refbacks

  • There are currently no refbacks.


Copyright (c) 2019 Aldino Satria Adhitya, Harris Hasan, Refli Hasan, A. Afif Siregar, Zulfikri Mukhtar, Ali Nafiah Nasution

Creative Commons License
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.



ACI (Acta Cardiologia Indonesiana) is indexed by: 

   

  

ACI (Acta Cardiologia Indonesiana) is published by:

Department of Cardiology and Vascular Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia

Address: Radiopoetro Building 2nd Floor, West Wing, Farmako Street, Sekip, Yogyakarta, Indonesia 55281

ACI (Acta Cardiologia Indonesiana) is endorsed by: