The Informative Value of Changes in the ST Segment for the Prognostication of Lethal Outcome within 30 Days in Patients with Acute Myocardial Infarction

Abstract

In this paper was analyzed the informative value of the multidimensional variable – the dislocation of the ST segment from the isoelectric line for the prognostication of lethal outcome (LO) within 30 days with the help of multivariate logistic regression and determined the risk groups for LO within 30 days. The study included 462 patients who for the first time experienced acute myocardial infarction (MI).The patients were followed up for 30 days from the onset of MI, including hospital period. In our patients the elevation or depression of the ST segment from isoline in ECG registered within the first hours ranged from 0 to 9 mm. The multivariate model was developed using only those ST segment markers whose p values of likelihood ratio statistic in multidimensional logistic regression model did not exceed 0,2. The models were developed using the variable removal method, taking into consideration the strong correlation between some markers. In this study for clinical practice was introduced the ST informative score (STS). When using ST score, the patients were differentiated into ST score 3 risk groups: low, medium and high. In the high risk group (ST score > 25) lethal outcome occurred in 31 % of patients, in the low risk group (ST score ≤ 11) lethal outcome occurred in 1.9 % of cases (p < 0.0001). Ill. 3, bibl. 10 (in English; summaries in Lithuanian, English and Russian).