The authors declared no conflict of interest.
Patients with Tombstoning Pattern on the Admission Electrocardiography Who Have Undergone Primary Percutaneous Coronary Intervention for Anterior Wall ST-Elevation Myocardial Infarction: In-Hospital and Midterm Clinical Outcomes
Article first published online: 13 AUG 2012
© 2012, Wiley Periodicals, Inc.
Annals of Noninvasive Electrocardiology
Volume 17, Issue 4, pages 315–322, October 2012
How to Cite
Ayhan, E., Isık, T., Uyarel, H., Ergelen, M., Cicek, G., Altay, S., Eren, M. and Michael Gibson, C. (2012), Patients with Tombstoning Pattern on the Admission Electrocardiography Who Have Undergone Primary Percutaneous Coronary Intervention for Anterior Wall ST-Elevation Myocardial Infarction: In-Hospital and Midterm Clinical Outcomes. Annals of Noninvasive Electrocardiology, 17: 315–322. doi: 10.1111/j.1542-474X.2012.00524.x
- Issue published online: 25 OCT 2012
- Article first published online: 13 AUG 2012
- myocardial infarction;
- tombstoning ST elevation
Background: A tombstoning pattern (T-pattern) is associated with in-hospital poor outcomes patients with ST-segment elevation myocardial infarction (STEMI), but no data are available for midterm follow-up. We sought to determine the prognostic value of a T-pattern on admission electrocardiography (ECG) for in-hospital and midterm mortality in patients with anterior wall STEMI treated with primary percutaneous coronary intervention (PCI).
Methods: After exclusion, 169 consecutive patients with anterior wall STEMI (mean age: 55 ± 12.9 years; 145 men) undergoing primary PCI were prospectively enrolled in this study. Patients were classified as a T-pattern (n = 32) or non–T-pattern (n = 137) based upon the admission ECG. Follow-up to 6 months was performed.
Results: In-hospital mortality tended to be higher in the T-pattern group compared with non–T-pattern group (9.3% vs 2.1% respectively, P = 0.05). All-cause mortality was higher in the T-pattern group than non–T-pattern group for 6 month (P = 0.004). After adjusting the baseline characteristics, the T-pattern remained an independent predictor of 6-month all-cause mortality (odds ratio: 5.18; 95% confidence interval: 1.25–21.47, P = 0.02).
Conclusion: A T-pattern is a strong independent predictor of 6-month all-cause mortality in anterior STEMI treated with primary PCI. Therefore, it may be an indicator of high risk among patients with anterior wall STEMI.