Factors indicating the best reperfusion method in acute myocardial infarction: Q wave better than time of onset

ABSTRACT

To evaluate the admission electrocardiogram [ECG] patterns as prognostic factors and compare the Q wave with other criteria such as time, for choosing the best treatment in acute myocardial infarction [AMI] Prospective case-control study Cardiac Emergency Departments of Imam Reza and Qaem Hospitals, Mashhad, Iran A total of 143 consecutive patients between year 2010 and 2012, diagnosed with AMI who were candidates for reperfusion therapy were enrolled. The admission and control post-thrombolytic therapy ECGs were taken for all subjects. Then admission ECG patterns, time to therapy and their relation with the reperfusion rate were analyzed. 60.1% [n = 86] of patients achieved 50% or more ST recovery [good response group] and 39.8% [n = 57] of patients had lower than 50% ST recovery [poor response group]. The mean response rate was significantly lower in patients presenting with Q wave [p 0.023]. In patients with initial Q wave, there was no significant difference in response rate whether they were treated within three hours from the onset of symptoms or not [p = 0.75]. In contrast, patients without Q wave who received thrombolytic therapy within first three hours had significantly higher reperfusion rates in comparison with those treated after three hours [p = 0.004]. It is suggested that, time from the onset of symptoms along with initial Q wave is better for decision making in AMI management, than the time alone