Introduction:

T-wave inversion has always been considered as a natural progression sign of the non-perfunded myocardial infarction, however it is also seen after early succesful reperfusion via fibrinolysis or primary angioplasty; its role in predicting auto-reperfusion has not been established.

Objective:

Assess the patency of the infarct-related artery (IRA) in patients presenting with early (< 3 hours of symptoms onset) T-wave inversion (TWI) in leads with ST-segment elevation (STE) myocardial infarction (STEMI).

Methods:

We retrospectively analyzed 432 patients admitted at the emergency department of the National Cardiology Institute in Mexico City with a diagnosis of STEMI who arrived within three hours of symptoms onset and underwent primary percutaneous coronary intervention (p-PCI) from October 2005 to November 2015. Clinical data, electrocardiogram (ECG) and angiographic data were reviewed. The subjects were divided in two groups: those with TWI and those with positive T waves (PTW).

Results:

386 (89.3%) patients presented with PTW and 46 (10.6%) with TWI. The presence of early TWI in anterior leads predicted patency of the anterior descending artery (LAD) (18 [69.2%] vs 41 [24%]; p < 0.001) but not in other arteries.

Conclusions:

The presence of early TWI in anterior leads with STE is associated with patency of the LAD. This relationship was not found in other infarct-related arteries.