ST peak during percutaneous coronary intervention serves as an early prognostic predictor in patients with ST-segment elevation myocardial infarction

Jacob Lønborg, Henning Kelbæk, Thomas Engstrøm, Steffen Helqvist, Lene Kløvgaard, Lene Holmvang, Niels Vejlstrup, Erik Jørgensen, Kari Saunamäki, Nadia P. Dridi, Anne Kaltoft, Hans Erik Bøtker, Peter Clemmensen, Christian Juhl Terkelsen

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Abstrakt

Aims: To evaluate the clinical importance of the ST peak phenomenon during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: Continuous ST monitoring was performed in 942 STEMI patients from arrival until 90 minutes after revascularisation. ST peak was defined as ≥1 mm increase in the ST-segment during PCI compared with the ST elevation before intervention. ST peak was observed in 26.9% of patients. During median follow-up of 4.1 years, 20.7% of patients experienced a major adverse cardiac event (MACE). ST peak was associated with higher rates of mortality (13.4% versus 9.3%; p=0.044), admission for heart failure (10.6% versus 5.2%; p=0.002) and MACE (26.9% versus 18.2%; p=0.002), but not reinfarction (7.1% versus 5.2%; p=0.14). In two different Cox regression analyses, adjusting for predictors of MACE and ST peak including ST resolution and epicardial flow, ST peak remained significantly associated with MACE: adjusted hazard ratio (HR) 1.40 (95% confidence interval [CI] 1.01-1.95) and 1.41 (95% CI: 1.02-1.96). Conclusions: In the largest study hitherto evaluating the ST peak phenomenon during primary PCI, we demonstrated that ST peak is a strong predictor of adverse long-term outcome and provides independent prognostic information beyond that provided by ST resolution and epicardial flow.

OriginalsprogEngelsk
Sider (fra-til)466-474
Antal sider9
TidsskriftEuroIntervention
Vol/bind10
Udgave nummer4
DOI
StatusUdgivet - 1 aug. 2014
Udgivet eksterntJa

Fingeraftryk Udforsk hvilke forskningsemner 'ST peak during percutaneous coronary intervention serves as an early prognostic predictor in patients with ST-segment elevation myocardial infarction' indeholder.

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