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

Research output: Contribution to journalJournal articlepeer-review

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

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.

Original languageEnglish
JournalEuroIntervention
Volume10
Issue number4
Pages (from-to)466-474
Number of pages9
ISSN1774-024X
DOIs
Publication statusPublished - Aug 2014

ID: 137622682