Prognostic Impact of Early ST-Segment Resolution and Biochemical Markers in Patients With ST-Elevation Myocardial Infarction

• The author has no financial conflicts of interest. cc This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licens-es/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Considerable variability exists for the reported mortality risk among patients with ST-elevation myocardial infarction (STEMI) and who are treated with primary percutaneous coronary intervention (PCI). The diversity in the clinical outcomes for these patients challenges the physician at each step: risk stratification, planning the treatment and monitoring the response to PCI. In this regard, the current guidelines for the treatment of patients with acute coronary syndrome (ACS) recommend risk stratification using a variety of clinical variables. Clinical variables such as biomarkers, electrocardiogra-phy (ECG), and the imaging modalities have been studied for whether these variables may improve the risk assessment and clinical care. The standard 12-lead ECG has been used as the single most important diagnostic tool for the evaluation of ACS. Measurement via ECG is very useful and informative for determining the quality of reperfusion in patients with acute STEMI. The degree of ST segment deviation also confers prognostic information. Since it was first documented in 1971 in an animal study that the magnitude of ST segment elevation was well correlated well with depressed myo-cardial creatine kinase activity as well as myocardial necro-sis, 2) the degree of ST segment elevation has been used as an index of the severity of myocardial ischemic injury. Successful recanalization of the epicardial coronary arteries by PCI does not ensure microvascular reperfusion, which is strongly correlated with the cardiovascular outcome. The ST-segment changes reflect the status of myocardial tissue perfusion, and so this may provide prognostic information beyond that suggested by a coronary angiogram. 3) The consistent relationship between the degree of ST resolution and the risk for death and congestive heart failure in patients who are treated with fibrinolytic therapy has been previously reported. Woo et al. 6) evaluated the resolution of the sum of ST-segment elevation (sum STR) 60 minutes after primary PCI as well as the biochemical markers to determine the prognostic value of these indices in patients with STEMI. That study showed that an incomplete sum STR is associated with a poor Killip class, delayed PCI, a decreased ejection fraction and increased baseline biomarkers, including high sensitivity C-reactive protein (hs-CRP), troponin I (TnI) and N-terminal …