Vol. 5, Issue 11 (2019)
Correlation of angiographic severity in patients with ST segment elevation myocardial infarction association with reciprocal ST segment depression
Author(s): Lakshman Chandra Barai, Md. Anisul Goni Khan, Md. Abul Kalam Azad, Md. Khandker Parvez Ahmad, Al-Mamun Hossain
Abstract: Background: The importance of reciprocal ST segment depression throughout acute infarct has been a region of dialogue, whether or not it's a symptom of multivessel unwellness, ischemia at a distance or just a benign physical phenomenon. Objective: To study the relation between the presences or without angiographic severity in patients with ST segment elevation myocardial infarction association with reciprocal ST segment depression. Methods: A prospective study involving two hundred ST elevation infarction patients (100 inferior, 100 anterior), every cluster was sub-grouped into a pair of subgroups consistent with the presence of reciprocal ST segment depression or absence: in anterior STEMI cluster we have a tendency to had subgroup A1 with RSTD (41 patients) and subgroup A2 while not RSTD (59 patients) whereas in inferior STEMI cluster every sub-group (B1 and B2) consisted of fifty patients. Coronary angiography was done in all patients within 15 days of acute ST segment elevation with RSTD or without RSTD having including primary PCI, thrombolytic therapy and SC LMWH. Results: This study revealed patients with reciprocal ST segment depression showed a significant lower mean Left ventricular ejection fraction and coronary artery disease of greater extent compared to those without (37 + 3% vs 53 + 5% P < 0.001, anterior ST elevation myocardial infarction subgroups) & (47 + 4% vs 60 + 3% P < 0.001, inferior ST elevation myocardial infarction sub-groups). Multivessel disease was higher incidence of found in subgroups with reciprocal ST segment depression (80.5% vs 49.2%, P < 0.001 in ST elevation anterior myocardial infarction) & (60% vs 20%, P < 0.001 in inferior ST elevation myocardial infarction). The mean Gensini score was modified higher in subgroups with reciprocal ST segment depression (64.2 + 12.6 vs 30.2 + 6.6, P < 0.001 in anterior infarction group) & (36.2 + 10.6 vs 20.4 + 4.2, p < 0.001 in inferior infarction group). Conclusion: Reciprocal ST segment depression in acute myocardial infarction associated with significant LV systolic dysfunction & coronary artery disease of greater extent.