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.
|Tidsskrift||Journal of Electrocardiology|
|Status||Udgivet - 1 nov. 2012|