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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, BACKGROUND, METHODS, RESULTS. Meshes: Aged, Aged, 80 and over, Biomarkers, Chi-Square Distribution, Coronary Angiography, Creatine Kinase, MB Form, Disease-Free Survival, Electrocardiography, Female, Heart Diseases, Humans, Logistic Models, Male, Middle Aged, Multivariate Analysis, Non-ST Elevated Myocardial Infarction, Percutaneous Coronary Intervention, Predictive Value of Tests, Proportional Hazards Models, Retrospective Studies, Risk Factors, ST Elevation Myocardial Infarction, Time Factors, Treatment Outcome, Troponin I.
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Is sT-segment elevation on intracoronary electrocardiogram after percutaneous coronary intervention associated with worse outcome in patients with non-ST-segment elevation myocardial infarction? Context: We sought to examine whether intracoronary electrocardiogram (IC-ECG) assessment in patients with non-ST-segment elevation myocardial infarction (NSTEMI) can predict cardiac outcomes. There has been no data correlating myocardial damage and cardiac events with an IC-ECG ST-segment change after percutaneous coronary intervention (PCI) in NSTEMI patients. We examined 111 NSTEMI patients undergoing PCI with an IC-ECG recording. IC-ECG ST-segment elevation (STE) was defined as >0.1 mV in the risk area, located by placing the guidewire distal to the culprit lesion. Clinical characteristics and in-hospital and long-term follow-up adverse cardiac event rates were compared between IC-ECG STE and non-IC-ECG STE groups at the completion of PCI. IC-ECG STE was observed in 36 patients (32.4%) immediately after PCI. Peak cardiac biomarkers were significantly elevated in patients with IC-ECG STE versus those without (cardiac troponin I 31.9 ng/mL (18.0-104.5) vs. 8.2 ng/mL (1.8-21.4); P < 0.001). At a median follow-up of 35 months, the cardiac event free rate was significantly worse in patients with IC-ECG STE than in those without (long-rank test χ(2) = 10.9; P = 0.001). Cox proportional hazards analysis showed IC-ECG STE (hazard ratio, 2.54; 95% confidence interval [CI], 1.38-4.70; P = 0.003) was an independent predictors of cardiac events.
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The present study suggests that presence of IC-ECG STE might help identify high-risk NSTEMI patients with greater myocardial injury leading to adverse cardiac events. Final Decision: yes