What is the best ST-segment recovery parameter to predict clinical outcome and myocardial infarct size? Amplitude, speed, and completeness of ST-segment recovery after primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.


Journal Article

AIMS: ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. METHODS AND RESULTS: Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined. Multiple ST measures (STR at last contrast injection (LC) measured from peak value; 30, 60, 90, 120, and 240min, residual deviation; time to steady ST recovery; and the 3-h area under the time trend curve [ST-AUC] from LC) were univariably correlated with IS and predictive of mortality. After multivariable adjustment for ST-parameters and GRACE risk factors, STR at 240min remained an additive predictor of mortality. Early STR, residual deviation, and ST-AUC remained associated with IS. CONCLUSIONS: Multiple parameters that quantify the speed, amplitude, and completeness of STR predict mortality and correlate with IS.

Full Text

Duke Authors

Cited Authors

  • Kuijt, WJ; Green, CL; Verouden, NJW; Haeck, JDE; Tzivoni, D; Koch, KT; Stone, GW; Lansky, AJ; Broderick, S; Tijssen, JGP; de Winter, RJ; Roe, MT; Krucoff, MW

Published Date

  • November 2017

Published In

Volume / Issue

  • 50 / 6

Start / End Page

  • 952 - 959

PubMed ID

  • 29153151

Pubmed Central ID

  • 29153151

Electronic International Standard Serial Number (EISSN)

  • 1532-8430

Digital Object Identifier (DOI)

  • 10.1016/j.jelectrocard.2017.04.009


  • eng

Conference Location

  • United States