Assessment of Coronary No-reflow in Patients with Acute Anterior STEMI Underwent Primary Percutaneous Coronary Intervention Using P Wave Peak Time Parameter

Author : P. Andri, M. Meidianaser, Syaoqi, S. Masrul
Upload Date : 19-04-2018

Background: Coronary no-reflow (NR) following primary percutaneous coronary intervention (PPCI) is associated with worsened prognosis in patients with ST segment elevation myocardial infarction

(STEMI). Despite rapid developments in cardiovascular area; there are limited data regarding prediction of  NR before PPCI. P wave duration and dispersion (PWD, PWDIS, respectively) have been studied in STEMI patients and found to be associated with reperfusion success; however none of them  has been found to predict NR before PCI. In this study, we aimed to evaluate whether PWD, PWDIS and a novel parameter P wave peak time (PWPT) could predict NR development in STEMI patients.

Methods: In this retrospective analysis, we evaluate 30 patients who were admitted with anterior STEMI from January 2017 – December 2017 at M. Djamil General Hospital Padang, Indonesia. P wave parameters including PWD, PWDIS and PWPT were calculated from electrocardiograms that were obtained on admission and 60 min after PPCI

Results: Patients were divided into two groups according to the development of NR. We observed that PWPT that were obtained from leads II (PWPTLII) and V1 (PWPTV1) were longer in NR group than reflow group. There were a correlations between PWPT and reperfusion parameters regarding percent of ST segment resolution, peak CKMB level and TIMI frame count of infarct related artery. Preprocedural PWPTLII was found to be an independent predictor of NR development.

Conclusion: In this study we observed that PWPT could be a useful parameter in the assessment of  reperfusion success and prediction of NR development.

KEYWORDS : P wave peak time; Myocardial infarction; Coronary No-reflow

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