title: ST peak during primary percutaneous coronary intervention predicts final infarct size, left ventricular function, and clinical outcome.
abstract: OBJECTIVE
  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]).
  
  
  CONCLUSIONS
  ST peak during primary PCI is related to larger final infarct size, a reduced EF, and adverse cardiac clinical outcome.
authors: Department of Cardiology, Rigshospitalet, Copenhagen, Denmark. jacoblonborg@gmail.com
authors: Jacob
authors: J
authors: Lønborg
authors: Henning
authors: H
authors: Kelbæk
authors: Lene
authors: L
authors: Holmvang
authors: Niels
authors: N
authors: Vejlstrup
authors: Erik
authors: E
authors: Jørgensen
authors: Steffen
authors: S
authors: Helqvist
authors: Kari
authors: K
authors: Saunamäki
authors: Nadia P
authors: NP
authors: Dridi
authors: Kiril Aleksov
authors: KA
authors: Ahtarovski
authors: Christian Juhl
authors: CJ
authors: Terkelsen
authors: Hans Erik
authors: HE
authors: Bøtker
authors: Won Yong
authors: WY
authors: Kim
authors: Marek
authors: M
authors: Treiman
authors: Peter
authors: P
authors: Clemmensen
authors: Thomas
authors: T
authors: Engstrøm
mesh_terms: D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery*; D062645:Percutaneous Coronary Intervention / Q000401:mortality*; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000401:mortality* / Q000517:prevention & control*