Predictive factors and short-term prognosis of acute myocardial infarction patients with spontaneous reperfusion

Objective To investigate the clinical implications of different evaluation methods and the short-term prognosis of spontaneous reperfusion in ST-segment elevation myocardial infarction. Methods Two hundred and two consecutive ST-segment elevation myocardial infarction patients underwent coronary angiography from January 2009 to August 2010 in Xuanwu Hospital were enrolled. Patients were divided into spontaneous reperfusion (SR, TIMI flow grade 3 identified by coronary angiogram) group and nonspontaneous reperfusion (NSR, TIMI flow grade 0-2 identified by coronary angiogram) group. We analyzed the predictive value of symptoms and ECG changes in spontaneous reperfusion in acute myocardial infarction and the incidence of cardio-cerebrovascular events during hospitalization. Results SR occurred in 38 (19.4%) patients and NSR in 169 (81.6%) patients. 42.1% of the patients in SR group and 14.8% in NSR group had more than 50% recovery of elevated ST segment (P 50% were 42.1%, 85.2%, 39.0% and 86.7%, respectively, and those of symptoms release >80% were 53.3%, 91.0%, 55.2% and 90.3%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value of the combination of ST segment recovery >50% and symptoms release >80% were 13.3%, 98.6%, 66.7% and 84.5%, respectively. The incidence of short-term cardio-cerebrovascular events between SR group and NSR group were similar(13.2% vs. 25.4%, P=0.285). Conclusions Symptom relief and ST segment recovery have certain predictive value of SR. The incidence of short-term cardio-cerebrovascular events has a trend of decrease in SR patients. Key words: Myocardial infarction; Spontaneous reperfusion; Electrocardiogram; Prognosis