FURTHER ST ELEVATION AT REPERFUSION BY DIRECT PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY PREDICTS POOR RECOVERY OF LEFT-VENTRICULAR SYSTOLIC FUNCTION IN ANTERIOR WALL AMI

Some patients with acute myocardial infarction (AMI) develop further S T elevation at reperfusion by percutaneous transluminal coronary angio plasty (PTCA). This study reports the ST deviation at reperfusion by d irect PTCA in relation to the clinical factors and the recovery of lef t ventricular (LV) systolic function. Fifty-two patients with anterior wall AMI were treated with direct PTCA. They were classified into the following 3 groups according to the change in ST elevation at reperfu sion: increase of greater than or equal to 20% (ST reelevation); reduc tion of greater than or equal to 20% (ST resolution); and the other (S T no change). Angina pectoris preceding AMI occurred less often in the ST reelevation group (ST reelevation group, 38%; ST no change group, 81%; ST resolution group, 70%; p <0.05). Recovery of LV ejection fract ion during the first month after direct PTCA was significantly poor in the ST reelevation group in contrast to the ST resolution group (ST r eelevation group, -6.3 +/- 13%; ST no change group, 18 +/- 20%; ST res olution group, 45 +/- 29%; p <0.0001). The change in ST elevation at r eperfusion was an index predicting the recovery of LV systolic functio n in the reperfusion by direct PTCA. (C) 1997 by Excerpta Medico, Inc.