ST-segment Resolution as a Predictor of Short-term Clinical Outcomes in Patients With Acute Anterior ST-elevation Myocardial Infarction After Primary Percutaneous Coronary Intervention

Background: Acute anterior ST-elevation myocardial infarction (STEMI) carries a high risk of adverse outcomes despite advances in reperfusion therapy. ST-segment resolution (STR) on electrocardiography has been proposed as a simple marker of myocardial reperfusion and predictor of clinical, but its prognostic role in routine practice remains debated. Aim of the Work: To assess the efficacy of ST-segment resolution as a predictor of short-term clinical outcomes in patients with acute anterior STEMI undergoing primary percutaneous coronary intervention (PCI). Patients and Methods: A prospective observational study was conducted at Mansoura University Cardiology Department between January and June 2024. 98 patients with anterior STEMI undergoing primary PCI were included. Patients were categorized into three groups: complete STR (≥70%), incomplete STR (30–70%), and no STR (≤30%), assessed 90 minutes post-PCI. Patients were followed for 40 days for the occurrence of major adverse cardiovascular events (MACE), including cardiovascular death, heart failure, re-infarction, revascularization, or stroke. Results: Of the 98 patients (mean age 56.3 ± 9.6 years; 86.7% male), complete STR was achieved in 37 (37.8%), incomplete STR in 49 (50%), and no STR in 12 (12.2%). The incidence of MACE was significantly lower in the complete STR group (p < 0.05). Logistic regression identified incomplete or absent STR as independent predictors of MACE. Conclusion: ST-segment resolution following primary PCI is a simple, inexpensive, and reliable tool for predicting short-term outcomes in anterior STEMI.