TY - JOUR
T1 - ST peak during primary percutaneous coronary intervention predicts final infarct size, left ventricular function and clinical outcome
AU - Lønborg, J
AU - Kelbæk, Henning Skov
AU - Holmvang, Lene
AU - Vejlstrup, Niels Grove
AU - Jørgensen, Erik
AU - Helqvist, Steffen
AU - Saunanaki, Kari I.
AU - Dridi, NP
AU - Ahtarovski, A
AU - Terkelsen, CJ
AU - Bøtker, HE
AU - Kim, WY
AU - Treiman, Marek
AU - Clemmensen, P
AU - Engstrøm, T
PY - 2012/11
Y1 - 2012/11
N2 - Background and Purpose: One third of patients treated with primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction develop a secondary increase in electrocardiographic ST segment (ST peak) during reperfusion. The purpose was to determine the clinical importance of ST peak during primary PCI. Methods: A total of 363 patients with ST-elevation myocardial infarction were stratified to no ST peak or ST peak. Final infarct size and ejection fraction (EF) were assessed by cardiovascular magnetic resonance. Results: Patients with ST peak had a larger infarct size (14% vs 10%; P =.003) and lower EF (53% vs 57%; P =.022). Rates of cardiac mortality (8% vs 3%; P =.047) and cardiac events (cardiac mortality and admission for heart failure; 19% vs 10%; P =.018) were higher among patients with ST peak, but not all-cause mortality (8% vs 5%; P =.46). In a multivariable Cox regression analysis, ST peak remained significantly associated with cardiac events (adjusted hazard ratio, 2.03 [1.08-3.82]). Conclusion: ST peak during primary PCI is related to larger final infarct size, a reduced EF, and adverse cardiac clinical outcome.
AB - Background and Purpose: One third of patients treated with primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction develop a secondary increase in electrocardiographic ST segment (ST peak) during reperfusion. The purpose was to determine the clinical importance of ST peak during primary PCI. Methods: A total of 363 patients with ST-elevation myocardial infarction were stratified to no ST peak or ST peak. Final infarct size and ejection fraction (EF) were assessed by cardiovascular magnetic resonance. Results: Patients with ST peak had a larger infarct size (14% vs 10%; P =.003) and lower EF (53% vs 57%; P =.022). Rates of cardiac mortality (8% vs 3%; P =.047) and cardiac events (cardiac mortality and admission for heart failure; 19% vs 10%; P =.018) were higher among patients with ST peak, but not all-cause mortality (8% vs 5%; P =.46). In a multivariable Cox regression analysis, ST peak remained significantly associated with cardiac events (adjusted hazard ratio, 2.03 [1.08-3.82]). Conclusion: ST peak during primary PCI is related to larger final infarct size, a reduced EF, and adverse cardiac clinical outcome.
U2 - 10.1016/j.jelectrocard.2012.06.028
DO - 10.1016/j.jelectrocard.2012.06.028
M3 - Journal article
C2 - 22832151
SN - 0022-0736
VL - 45
SP - 708
EP - 716
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
IS - 6
ER -