Document Detail

ST peak during percutaneous coronary intervention serves as an early prognostic predictor in patients with ST-segment elevation myocardial.
MedLine Citation:
PMID:  25138184     Owner:  NLM     Status:  In-Data-Review    
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.
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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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  10     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2014 Aug 
Date Detail:
Created Date:  2014-08-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  France    
Other Details:
Languages:  eng     Pagination:  466-74     Citation Subset:  IM    
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