Registry of Patients with STEMI Equivalent Electrocardiography Undergoing Percutaneous Coronary Intervention

Abstract

Background: Acute reperfusion therapy, namely primary percutaneous coronary intervention (PCI), is the mainstay of treatment for ST segment elevation myocardial infarction (STEMI). This work aimed to evaluate STEMI equivalent in patients admitted at cardiac care centre, Tanta university. Methods: This prospective observational registry was done on 50 patients aged from 39 to 81 years old, both genders, presented with electrocardiographic (ECG) findings of STEMI equivalent (De Winter syndrome-Wellen syndrome - elevation in aVR and global ST segment depression) undergoing PCI. Coronary angiography done to assess angiographic lesion then reperfusion through PCI for infarct related artery (IRA) done. Results: 74% of patients were classified as KILLIP I, positive troponin was found in 90 % of patients a. Average creatine kinase-myocardial band (CKMB) value was 64.34. 60% of patients were classified as intermediate risk on global registry of acute coronary events (GRACE) score, only 16% of study population were high risk GRACE score. Multi vessel disease was double time more than single vessel affection with Left anterior descending (LAD) artery as the most frequent culprit artery (88%) followed by left main (LM) artery (10%). Major adverse cardiac events (MACE) occurred in 18% of study population. No patients died during hospital stay or suffered from re-infarction or stroke during hospital stay. Conclusions: Identifying individuals
with STEMI-equivalents, such as NSTEMI, provides an opportunity for timely intervention by rapid coronary angiography. Immediate reperfusion is crucial for these individuals, since their death rate remains elevated in the absence of therapy.