Abstract
Regression of ST segment elevation after reperfusion is a strong prognostic factor in ST Elevation Myocardial Infarction (STEMI) patients. Up to 25% patients have ST segment re-elevation after the initial regression and there is little data regarding its prognostic significance. Standard 12-leads electrocardiograms (ECG) were recorded in 662 anterior STEMI patients referred for Primary Percutaneous Coronary Intervention (PPCI), from the CIRCUS trial. ECGs were recorded at admission, 60–90 minutes after PPCI, and at discharge. ST segment elevation was measured on STmax, and ST segment re-elevation was defined by an increase ≥ 0.1 mV between post-PPCI and discharge ECG. Infarct size by Creatin Kinase (CK) peak, echocardiography at baseline and follow-up, and all-cause death and heart failure events were assessed at one year. 128 (19%) patients had ST segment re-elevation (ReST+ group). There was no difference between ReST+ patients and patients without re-elevation (ReST− group) on infarct size (CK peak: 4231 ± 2656 IU/l vs. 3993 ± 2819 IU/l, respectively, P = 0.402). There was no difference for 1-year Left Ventricular (LV) Ejection Fraction (50.7 ± 11.6% vs. 52.2 ± 10.8%, P = 0.186) or LV adverse remodeling (20.1 ± 38.9% vs. 18.3 ± 30.9%, P = 0.631). There was no difference in all-cause mortality and heart failure events at one year (22 [19.8%] vs. 106 [19.2%], P = 0.887). In anterior STEMI patients treated by PPCI, ST segment re-elevation was present in 19% and was not associated with increased infarct size and major adverse events at one year.
Published Version
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