Prognostic impact of terminal T wave inversions on presentation in patients with ST-Elevation myocardial infarction undergoing urgent percutaneous coronary intervention

IntroductionTerminal T wave inversions (TTWI) indicate advanced stages of ST-elevation myocardial infarction (STEMI). The present study investigated whether TTWI predict unfavorable in-hospital outcomes in STEMI patients treated with urgent percutaneous coronary intervention (PCI).MethodsA retrospective cohort study was performed with consecutive 188 STEMI cases undergoing urgent PCI. The primary endpoint was in-hospital major adverse cardiac event (MACE), and the secondary endpoints were ST resolution (STR) after PCI and length of stay (LOS).ResultsTTWI on presentation were independently associated with higher incidence of in-hospital MACE (adjusted OR 2.8; 95% CI 1.1–7.0; p = 0.03), inadequate STR (adjusted OR 5.5; 95% CI 2.1–14.3; p = 0.01), and longer LOS (adjusted mean increase 4.1 days; 95% CI 0.3–7.9; p = 0.03). TTWI predicted these outcomes better than patient-reported ischemic time or pathologic Q waves.ConclusionsTTWI on presentation are an independent risk factor for poor inpatient prognosis among patients presenting with STEMI undergoing urgent PCI.