Abstract. Early and complete ST segment resolution after primary coronary angioplasty is a strong and independent predictor of successful reperfusion therapy. ST measurement points and resolution time effects on late outcomes are still not clear.

Aim. Relationship between ST segment resolution at 60 minutes after percutaneous coronary intervention and Major Adverse Cardiac and Cerebral Events (MACCE) at 6 months of hospital discharge.

Material and Methods. From June 2001 to July 2002, 497 consecutive patients between 29-86 years old with ST elevation myocardial infarction were enrolled in this study. All patients were on continuous ST segment resolution monitoring (Cardiology Review Station, Siemens, Germany). Although risk of its oversensitivity, 20 msec after J point had been taken as measurement points default on ECG monitors. Patients with cardiogenic shock prior cathlab admission, previous myocardial infarction, right ventricular myocardial infarction, previous coronary artery bypass surgery, prior left ventricular aneurism, multivessel coronary artery disease, longer chest pain time (chest pain to balloon time is > 6 hours), and peripheral artery disease were excluded. Patients were divided into three groups; 1- Complete ST resolution (>70 %), 2- Partial ST resolution (30-70 %), and 3- No ST resolution (<30 %) at 60 minutes after PCI. After 6 months of hospital discharge exercise stress tests and echocardiographic examinations have been done.

Results. 226 (45.48 %) patients had complete ST segment resolution, 174 (35.01 %) patients had partial ST segment resolution, and 97 (19,51 %) patient had no ST segment resolution at 60 minutes after primary coronary angioplasty. Patients in group 1 had significantly higher exercise tolerance capability, better left ventricular ejection fraction than group 3, and MACCE free survival at 6 months period (p values were 0.019, 0.024, 0.00062 respectively) regardless of primary PCI or prior adjunctive drug therapy. During follow up 486 (97.78 %) patients had been examined. 11 patients (2.22 %) died in this period, and 458 of them (92.15 %) had all two examinations. 98 patients (56.32 %) in group 2 had similar symptoms and examination findings of group 3.

Conclusion. 60 minutes after primary coronary angioplasty is optimum time for ST segment analysis. When 20 msec after J point has been taken on ECG monitors, ST segment resolution time is strong and independent prognostic indicator of MACCE at 6 months period.