Associassion of avr ST segment deviations with in-hospital and long term mortality of patients with first anterior ST-elevation MI treated with primary angiography

Abstract

Acute heart attack is one of the most important and common causes of death worldwide and at different ages, and on the other hand, with current treatments, the complications after heart attack can be prevented to some extent, with appropriate treatment as soon as possible from the costs to prevent excess for the patient and the treatment system. it is always possible to find out the vessel that caused the infarction based on the ECG to a large extent, and based on the type of vessel and its importance based on the size of the area that perfuse it, and classify the patients with higher risk and estimated the probability of complications caused by it and prevented them with faster treatments. Purpose: The general purpose of this project is to evaluate the relationship between ST segment changes in AVR lead in patients with the first acute anterior STEMI who undergo coronary angiography, in terms of in-hospital and long-term complications. Material and methods : In this study, which is a cross-sectional descriptive analytical study, among the patients referred to the emergency department of Shahid Madani Cardiology Hospital in Tabriz between April 2014 and March 2019, 335 patients were included in the study and according to the findings of angiography and ECG in one of the three groups, with ST segment drop, rise or stability in AVR lead at the first moment of referral and ninety minutes after reperfusion was divided and along with other demographic and echocardiographic findings, the relationship between complications and in-hospital and long-term mortality after discharge in these patients was evaluated with ST segment changes with SPSS software. Results: Among the 303 patients, 82 patients were aVRSTD, 113 patients were aVRSTE, and 35.7% were without the mentioned lead changes. Among the 192 cases of patients with avr lead changes who underwent angiography, the improvement of the changes after angiography was seen in 71.9% of cases, and 28.1% of the patients did not have any change. A total of 191 patients (63%) had in-hospital complications, there was a significant relationship between in-hospital complications and the rise of aVRST segment in the third subgroup with changes of more than 1 mm with p value = 0.01. In terms of changes in the aVRST lead, there was a significant relationship with in-hospital complications in total with p vqlue = 0.04 and in the examination of individual subgroups in patients, p value = 0.22 and in the third subgroup with a greater decrease from 1 mm, p value = 0.001, as a result, this relationship was statistically significant only in the third subgroup. 90 patients, (29.7%), had long-term complications in terms of the relationship between long-term complications and the elevation of the aVRST segment, in total, with p value = 0.53, no significant relationship was seen, and no significant relationship was seen in the examination of individual subgroups. In terms of the relationship between long-term complications and aVRST depression, no statistically significant relationship was seen.