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ISSN: 1899-1874
Medical Studies/Studia Medyczne
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4/2023
vol. 39
 
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abstract:
Original paper

The impact of ECG at admission and a culprit lesion on 12-month outcomes in acute myocardial infarction – analysis based on the PL-ACS Registry

Łukasz Piątek
1
,
Karolina Piątek
1
,
Michał Skrzypek
2
,
Mariusz Gąsior
3
,
Marianna Janion
1
,
Zbigniew Siudak
1
,
Marcin Sadowski
1

  1. Collegium Medicum, Jan Kochanowski University, Kielce, Poland
  2. Department of Biostatistics, School of Health Sciences in Bytom, Medical University of Silesia in Katowice, Poland
  3. 3rd Department of Cardiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia in Katowice, Silesian Centre for Heart Disease, Zabrze, Poland
Medical Studies/Studia Medyczne 2023; 39 (4): 327-333
DOI: https://doi.org/10.5114/ms.2023.134083
Online publish date: 2023/12/30
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Introduction
Acute myocardial infarction (MI) is usually associated with ischaemic abnormalities in electrocardiography (ECG). However, a considerable proportion of MI cases present with no ischaemic changes (NIC). The exact impact of the ECG pattern and a culprit lesion on long-term outcomes in the era of routine percutaneous coronary interventions remains unclear.

Aim of the research
To analyse baseline characteristics and 12-month outcomes of MI patients with various ECG patterns on admission as well as the exact impact of a culprit lesion on the long-term prognosis.

Material and methods
Based on PL-ACS Registry data, we analysed patients admitted to Polish hospitals in 2015–2020 due to MI. A total of 111,689 cases who underwent primary percutaneous coronary intervention were included in the study. Based on initial ECG, 5 groups were established: ST segment elevation (STE), ST segment depression (STD), T-wave inversion (TWI), other ST-T abnormalities (STT), and no ischaemic changes (NIC).

Results and conclusions
NIC patients accounted for over 10% of all MI cases. In-hospital mortality in NIC was higher than TWI but lower than in STE, STD, and STT. In 12-month follow-up NIC had worse prognosis than TWI and STE. STT and STD presented with the worst prognosis, which is associated with adverse factors like comorbidities, heart failure, and multi-vessel coronary disease. The impact of a culprit lesion on 12-month outcomes was equal for right coronary artery (RCA), obtuse marginal branch (OM), diagonal (D), and circumflex artery (Cx), i.e. it is negligible except for both LM and LAD.

keywords:

electrocardiography, culprit lesion, myocardial infarction, ischaemic changes
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