REVIEW ARTICLE
ST segment resolution as a tool for assessing the efficacy of reperfusion therapy
James A. de Lemos, MD*,* and
Eugene Braunwald, MD, FACC
* Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts, USA
Manuscript received February 1, 2001;
revised manuscript received July 11, 2001,
accepted July 26, 2001.
* Reprint requests and correspondence: Dr. James de Lemos, University of Texas, Southwestern Medical School, 5323 Harry Hines Boulevard, Room CS 7.412, Dallas, Texas 75093-9034 USA
james.delemos{at}utsouthwestern.edu
Rapid, simple and inexpensive measures are needed to assess the efficacy of reperfusion therapy both in clinical practice and in clinical trials testing novel reperfusion regimens. In the last decade, several observations have led to a favorable reappraisal of the utility of ST segment monitoring as a simple means of assessing reperfusion in patients receiving fibrinolytic therapy for acute ST elevation myocardial infarction, and ST resolution is being used increasingly in clinical practice and in clinical research. This review focuses on four interrelated roles for ST segment monitoring: the assessment of epicardial reperfusion and the identification of candidates for rescue percutaneous coronary intervention; the evaluation of microvascular and tissue-level reperfusion; the determination of prognosis early after fibrinolytic therapy; and the use of ST segment resolution to compare different reperfusion regimens.
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Abbreviations and Acronyms
| | CHF | = congestive heart failure | | GP IIb/IIIa | = glycoprotein IIb/IIIa | | GUSTO | = Global Use of Strategies to Open Occluded Coronary Arteries trial | | IRA | = infarct-related artery | | MI | = myocardial infarction | | MRI | = magnetic resonance imaging | | PCI | = percutaneous coronary intervention | | PET | = positron emission tomography | | STEMI | = ST elevation myocardial infarction | | TIMI | = Thrombolysis In Myocardial Infarction | | tPA | = tissue plasminogen activator |
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