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Revista mexicana de cardiología
versão impressa ISSN 0188-2198
Resumo
BARRERA-ORANDAY, Ernesto Alexis; CORTES DE LA TORRE, Juan Manuel; RODRIGUEZ CASTILLO, Juan Manuel e ARIAS-MENDOZA, Alexandra. Early T-wave inversion in anterior leads predict patency of the anterior descending artery in ST-segment elevation myocardial infarction. Rev. Mex. Cardiol [online]. 2018, vol.29, n.3, pp.120-125. ISSN 0188-2198.
Introduction:
T-wave inversion has always been considered as a natural progression sign of the non-perfunded myocardial infarction, however it is also seen after early succesful reperfusion via fibrinolysis or primary angioplasty; its role in predicting auto-reperfusion has not been established.
Objective:
Assess the patency of the infarct-related artery (IRA) in patients presenting with early (< 3 hours of symptoms onset) T-wave inversion (TWI) in leads with ST-segment elevation (STE) myocardial infarction (STEMI).
Methods:
We retrospectively analyzed 432 patients admitted at the emergency department of the National Cardiology Institute in Mexico City with a diagnosis of STEMI who arrived within three hours of symptoms onset and underwent primary percutaneous coronary intervention (p-PCI) from October 2005 to November 2015. Clinical data, electrocardiogram (ECG) and angiographic data were reviewed. The subjects were divided in two groups: those with TWI and those with positive T waves (PTW).
Results:
386 (89.3%) patients presented with PTW and 46 (10.6%) with TWI. The presence of early TWI in anterior leads predicted patency of the anterior descending artery (LAD) (18 [69.2%] vs 41 [24%]; p < 0.001) but not in other arteries.
Conclusions:
The presence of early TWI in anterior leads with STE is associated with patency of the LAD. This relationship was not found in other infarct-related arteries.
Palavras-chave : ST-segment elevation myocardial infarction; auto-reperfusion; T-wave inversion.