1. Correlation between post-PTCA resolution of ST segment and mortality in STEMI patients First author: Diana Opincariu Co-authors: Carmen Moldovan Daniel Balan Coordinators: Prof. Dr. Benedek Imre Prof. Dr. Benedek Theodora University of Medicine and Pharmacy Tg. Mures Cardiology Clinic, Mures Emergency Clinical County Hospital

2. Background The acute myocardial infarction causes changes in the electrical activity of the heart.

3. Background The extent of the necrosis can be decreased through Decrease in ST segment elevation ThrombolysisPTCA

4. Objective The present study aims to identify a correlation between mortality in STEMI patients and ST segment resolution following revascularization (PTCA)

5. Materials and methods Inclusion criteria Acute myocardial infarction with ST segment elevation Primary PCI (TIMI flow 2-3) within the first 12 h after onset of symptoms Exclusion criteria Left bundle branch block occured after the AMI History of heart surgery Age under 18 298 patients

6. Materials and methods ISSTE = integrated score of ST elevation ISSTE was calculated by summing the amplitudes of the ST segment elevations in all the leads (12 lead ECG)

7. Materials and methods ISSTE = integrated score of ST elevation The pre and post- revascularization (1-2 days after) ISSTE were calculated and compared. An efficient revascularization was defined as a decrease in the ISSTE score by >=50% The analysis of the data was performed by using MS Excel, GraphPad InStat and Fisher’s exact statistical test

8. Results The study population was divided into 2 groups Group 1 259 patients with >=50% decrease in the ISSTE Group 2 39 patients with a decrease in the ISSTE of <50%

9. Characteristics of the study population AGE GENDER NS NS NS NS NS NS NS NS

10. Infarct related artery RCA – right coronary artery, LAD – left anterior descendant; CxA– circumflex artery NS

11. Infarct related artery RCA – right coronary artery, LAD – left anterior descendant; CxA– circumflex artery NS

12. Results Group 1 = >=50% decrease in ISSTE Group 2 = decrease in ISSTE of <50% Group 1 Group 2 Total Number of cases25939298 Survivors24229271 Deceased171027 Mortality6.56%25.64% p=0.0008 93.44% 6.56% 73.36% 25.64%

13. Conclusions The study demonstrates the correlation between ST segment amplitude decrease, post-PTCA, and mortality in STEMI patients ISSTE is a new prognostic marker associated with post-myocardial infarction mortality A >50% decrease in the ISSTE score following revascularization is associated with a decrease in mortality in STEMI patients.

14. Special recognition to members of Cardiology Clinic, of the MURES COUNTY EMERGENCY CLINICAL HOSPITAL- Prof. Dr. Benedek Imre Prof. Dr. Benedek Theodora Thank you for your for your attention attention