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Objectives: Some patients with suspected ST-segment elevation (STE) myocardial infarction (STEMI) show STE that does not fulfill the current criteria for STEMI. The purpose of this study was to investigate the characteristics and prognoses of patients with minimal STEMI. Methods: Between November 2007 and December 2011, 546 patients who underwent primary percutaneous coronary intervention (PCI) for STEMI were enrolled. Results: The minimal STE group had a higher proportion of women (30.2 vs. 21.0%, p = 0.031), better pre-PCI antegrade flow (Thrombolysis in Myocardial Infarction flow 2-3, 30.2 vs. 18.8%, p = 0.006) and better collateralization (Rentrop score 2-3, 27.4 vs. 18.1%, p = 0.024) compared to the definite STE group. Multivariate analysis showed that each of them were independent predictors for minimal STE. However, 1-year mortality of the minimal STE group did not differ from that of the definite STE group (7.1 vs. 9.3%, log-rank p = 0.315). Conclusions: Female gender, good collateral flow and good pre-PCI antegrade flow were independent predictors for minimal STE in patients with STEMI. However, minimal STE was not related to a good prognosis in patients with STEMI. © 2014 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Little is known about risk factors for 6-month major adverse cardiac events (MACEs) in 30-day survivors after acute myocardial infarction (AMI). We investigated predictors of 6-month MACE in 30-day survivors after MI from the Korea Acute Myocardial Infarction Registry (KAMIR). From November 2005 to January 2008, 9,706 patients (6,983 men, mean age 64.0 ± 12.4 years) who survived >30 days after AMI were analyzed. The primary end point was 6-month MACEs including death, MI, and revascularization. During 6-month follow-up, 317 patients (3.2%) had MACEs including 66 (0.6%) deaths, 23 (0.2%) recurrent MIs, and 218 (2.2%) revascularizations. In multivariate logistic regression analysis, factors reflecting demographics (body mass index), severity of left ventricular systolic dysfunction (Killip class >I, in-hospital cardiogenic shock, use of intra-aortic balloon pump), residual myocardial ischemia (previous coronary heart disease, multivessel disease), and electrical instability (ventricular tachycardia/ventricular fibrillation on admission) were independent predictors of 6-month MACEs after adjustment for clinical, angiographic, and procedural data. Plasma level of N-terminal pro–B-type natriuretic peptide provided an additional prognostic value predicting 6-month MACEs. In conclusion, this study provides useful prognostic information for clinicians to advise patients who have survived the acute phase of MI. More intensive management is needed in survivors after MI with these high-risk features. [Copyright &y& Elsevier]