WEDNESDAY, Aug. 18 (HealthDay News) -- Occluded arteries and elevated cardiac biomarkers are not rare in acute coronary syndrome (ACS) patients with isolated anterior ST-segment depression, and these patients have worse clinical outcomes and are unlikely to undergo urgent angiography, according to research published in the August issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.
Yuri B. Pride, M.D., of the Beth Israel Deaconess Medical Center in Boston, and colleagues analyzed 1,198 ACS patients with isolated anterior ST-segment depression to determine the angiographic and clinical outcomes in this patient population.
The researchers found slightly more than a quarter (26.2 percent) had an occluded culprit artery (Thrombolysis in Myocardial Infarction [TIMI] flow grade 0/1) with elevated cardiac biomarkers (+Tn); slightly more than half (53.5 percent) had a patent culprit artery (TIMI flow grade 2/3) with +Tn; and 20.3 percent had TIMI flow grade 2/3 with −Tn. The composite of 30-day mortality and myocardial infarction was significantly higher in patients with an occluded artery (8.6 percent) than in those with a patent culprit artery with +Tn (6.3 percent) or −Tn (2.9 percent). The median time from electrocardiogram to percutaneous coronary intervention in patients with an occluded artery was 29.4 hours.
"Among ACS patients presenting with isolated anterior ST-segment depression, more than one-quarter had an occluded artery at the time of angiography," the authors write. "Less than 5 percent of patients with an occluded artery were recognized by clinicians as having an occluded artery and none underwent urgent angiography. This suggests the need for improved methods to identify patients with isolated anterior ST-segment depression who have an occluded artery."
The study was supported by a grant from Daiichi-Sankyo Company Ltd. and Eli Lilly and Company. Three authors disclosed financial ties to these and other pharmaceutical and/or medical device companies.
Abstract
Full Text (subscription or payment may be required)
