ECG Criteria for the Prediction of Infarct-Related Artery and Impact of Coronary Dominance on ECG in Patients with Inferior ST-elevation Myocardial Infarction

• Published in: Sakarya tıp dergisi Vol. 10; no. 4; pp. 669 - 676
• Main Authors: Eser Durmaz, Bilgehan Karadağ, Deniz Mutlu, Hasan Tokdil, Zeki Öngen, Cansu Ebren, Orhan Furkan Karaca, Ali Uğur Soysal, Sinem Güral Ünal
• Format: Journal Article
• Language: English
• Published: Sakarya University 01-12-2020
• Subjects: coronary artery dominance; ecg; ekg; inferior stemi; koroner arter baskınlığı
• ISSN: 2146-409X
• DOI: 10.31832/smj.777121

Background In-stent restenosis(ISR) is a common angiographic finding in patients with previous stent implantation. Although the mechanism and predictors of ISR has been well-defined, after definition of neoatherosclerosis, a new perspective was emerged and current guidelines recommended a new classification for myocardial infarction due to stent restenosis(Type 4C). In this study, we aimed to investigate the clinical risk factors and predictors of Type 4C myocardial infarction. Material/method We reviewed the local angiography database and patients diagnosed with ISR were extracted. Patients’ demographics, clinical characteristics and clinical outcomes were recorded. Type 4C myocardial infarction is defined as myocardial infarction due to stent restenosis. Results 332 patients were screened and after exclusion 192 patients were included to the final analyses. There were 32 patients with myocardial infarction(group 1). Mean follow-up time was …. months. There was no significant difference between groups with respect to age and gender. Hypertension was significantly more prevalent in group 2. Diabetes mellitus, previous cerebrovascular accident and hyperlipidaemia were comparable between groups, however smoking was significantly more prevalent in group 1. Logistic regression analyses revealed that smoking status and degree of stenosis due to ISR were only independent predictors of type 4C myocardial infarction. Cardiac mortality was significantly increased in patients with myocardial infarction. Conclusion Our study demonstrated that type 4C myocardial infarction should not be underestimated during the long-term follow-up of patients who were diagnosed with ISR. Moreover, since cardiac mortality significantly increases in patients with myocardial infarction, future studies for predictors of myocardial infaction is required.