Inversion of the T waves (T−) in electrocardiographic leads with ST-segment elevation
after the initiation of reperfusion therapy is considered a sign of reperfusion. However,
the significance of T− on presentation before the initiation of reperfusion therapy
is unclear. The aim of this study was to assess whether T− on presentation predicts
patency of the infarct-related artery in patients with acute ST-segment elevation
myocardial infarctions (STEMIs) who undergo primary percutaneous interventions. The
medical records, electrocardiograms, and angiographic findings of 209 consecutive
patients who underwent emergent coronary angiography as part of primary percutaneous
coronary intervention protocol activation for STEMI were reviewed. A total of 179
patients (86%) had positive T waves (T+), 16 (8%) had biphasic T waves (T+/−), and
14 (7%) had T−. Patency of the infarct-related artery (Thrombolysis In Myocardial
Infarction [TIMI] flow grades 2 and 3) was seen in 64.3% of the patients in the T−
group compared with only 31.2% in the T+/− group and 19.0% in the T+ group (p <0.001).
Among patients with anterior STEMI, patency of the infarct-related artery was seen
in all 7 patients in the T− group, compared with 50% of the 4 patients in the T+/−
group and 10.1% of the 79 patients in the T+ group (p <0.001). There were no significant
differences in TIMI flow grade among the groups in patients with nonanterior STEMIs
(p = 0.985). In conclusion, T− in the leads with maximal ST-segment elevation on the
presenting electrocardiogram was associated with higher prevalence of patency of the
infarct-related artery before intervention (64.3%), especially in patients with anterior
STEMIs (100%).
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Article Info
Publication History
Published online: October 30, 2013
Accepted:
September 27,
2013
Received in revised form:
September 27,
2013
Received:
August 27,
2013
Footnotes
See page 274 for disclosure information.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
