Monday, May 10, 2021


REBEL EM - By Salim Rezaie - May 10, 2021
Paper: Meyers HP et al. Accuracy of OMI ECG Findings Versus STEMI Criteria for Diagnosis of Acute Coronary Occlusion Myocardial Infarction. IJC Heart & Vasculature 2021. [Link is HERE]
Clinical Question: Are OMI ECG findings more accurate than STEMI Criteria for the diagnosis of Acute Coronary Occlusion MI (ACO MI)?
Author Conclusion: “Blinded interpretation using predefined OMI ECG findings was superior to STEMI criteria for the ECG diagnosis of Occlusion MI. These data support further investigation into the OMI vs. NOMI paradigm and suggest that STEMI(-) OMI patients could be identified rapidly and noninvasively for emergent reperfusion using more accurate ECG interpretation.”
Clinical Take Home Point: Despite the confusing recruitment methodology, this is another trial that shows that there is a subgroup of NSTEMI patients (i.e. STEMI (-) OMI), who have acute large vessel coronary occlusions with similar outcome severity to STEMI (+) OMI patients. Despite the similar outcome severity, STEMI (-) OMI patients are much less likely to receive emergent cardiac catheterization in an expedited fashion compared to STEMI (+) OMI patients. STEMI (-) OMI patients are an under identified subgroup of STEMI patients that would benefit from emergent cardiac catheterization”