Clinical InvestigationAcute Ischemic Heart DiseaseTransient ST-elevation myocardial infarction: Clinical course with intense medical therapy and early invasive approach, and comparison with persistent ST-elevation myocardial infarction
Section snippets
Inclusion criteria
TSTEMI was defined by the presence of the following:
- 1.
clinical presentation of an acute STEMI including intense chest pain for at least 20 minutes and ST elevations on the ECG of at least 2 mm in 2 standard limb leads or in 2 contiguous chest leads. These patients were initially eligible and scheduled for reperfusion therapy with thrombolysis or PCI available at our center;
- 2.
complete resolution of electrocardiographic changes, that is, complete normalization of ST elevations without reperfusion
Patients
Sixty-nine consecutive patients with TSTEMI who fulfilled inclusion criteria were prospectively enlisted out of 1244 patients (5.5%) admitted for AMI during the study period. Of these, 63 (91%) were available for follow-up and could be evaluated more than 6 months after their index admission. The TSTEMI study group (age, 56.7 ± 11) included 48 men (age, 55.3 ± 11) and 15 women (age, 61.3 ± 12.5). For most patients (87%), this was the first presentation of coronary artery disease. The STEMI
Discussion
The optimal management of patients presenting with an acute STEMI and who have complete resolution of symptoms and electrocardiographic changes upon admission to the CCU, either spontaneous or after initial therapy with nitrates, aspirin, or heparin, has not yet been determined. In this study, we prospectively recorded all patients with TSTEMI admitted to the CCU from August 1999 to November 2005. These patients were scheduled, in light of their initial presentation, for reperfusion therapy.
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