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Aborted myocardial infarction in patients with ST-segment elevation

Insights from the assessment of the safety and efficacy of a new thrombolytic regimen-3 trial electrocardiographic substudy

Taha Taher, MD^*, Yuling Fu, MD^*, Galen S. Wagner, MD, Shaun G. Goodman, MD, Claudio Fresco, MD, Christopher B. Granger, MD, Lars Wallentin, MD^||, Frans Van de Werf, MD^¶, Freek Verheugt, MD^|| and Paul W. Armstrong, MD^*,*

^* University of Alberta, Edmonton, Alberta, Canada
Duke Clinical Research Institute, Durham, North Carolina, USA
Canadian Heart Research Centre and Terrence Donnelly Heart Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
Hospital S. Maria della Misericordi, Udine, Italy
^|| University Hospital Gasthuisber, Leuven, Belgium
^¶ University Medical Center St. Radboud, Nijmegen, The Netherlands

View larger version (24K): [in a new window]   Figure 1 Identification of aborted myocardial infarction (MI) and masquerading MI from Assessment of the Safety and Efficacy of a New Thrombolytic Regimen (ASSENT)-3 trial. CK = creatine kinase; ECG = electrocardiogram; ULN = upper limit of normal.

View larger version (22K): [in a new window]   Figure 2 Rate of aborted myocardial infarction (MI) according to time from symptom onset to treatment. p < 0.001 for trend comparison.

View larger version (24K): [in a new window]   Figure 3 ST-segment resolution at 60 and 180 min. p < 0.001 for trend comparison within each time point. Numbers represent percentage of patients in that category. Dark gray bars = <30% ST-segment resolution; light gray bars = 30% to 70% ST-segment resolution; white bars = 70% ST-segment resolution. MI = myocardial infarction.

View larger version (28K): [in a new window]   Figure 4 Clinical outcomes of aborted myocardial infarction (MI) patients according to extent of 60-min ST-segment resolution. *p = 0.002 for comparison between groups. White bars = aborted MI with 70 ST-segment resolution at 60 min (n = 300); gray bars = aborted MI with <70% ST-segment resolution at 60 min (n = 239).