Two hundred twenty patients with STEMI treated with thrombolysis were monitored for 24 hours with continuous online vectorcardiography assessing ST vector changes to record recurrent ischemic events.
Ischemic events measured as an increase in ST-change vector magnitude (STC-VM) more than 50 μV for at least 2 minutes during 4- to 24-hour predicted mortality in a 5-year follow-up based on a multivariable analysis (hazard ratio, 1.18/episode; confidence interval, 1.01-1.37). The more episodes there were, the worse the prognosis. A low-risk group with a 1-year mortality of 1.9 % could be identified.
Continuous ST-segment monitoring during the first 24 hours of a myocardial infarction is a valuable tool for identifying high- and low-risk patients. The STC-VM events during 4 to 24 hours of the first day of a myocardial infarction predict mortality within 5 years.