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<p>Time to peak creatine phosphokinase (CPK) has historically been used as a surrogate marker of reperfusion in ST-elevation myocardial infarction (STEMI), but its significance in the contemporary primary percutaneous coronary intervention (PCI) era remains uncertain. We retrospectively analyzed 239 consecutive STEMI patients who underwent primary PCI at Tsukazaki Hospital between January 2021 and December 2024. Patients were categorized according to final post-PCI TIMI flow: TIMI 3 (Group A, n=194) and non-TIMI 3 (Group B, n=45). The median time to peak CPK was significantly shorter in Group A compared with Group B (365.0 vs. 684.0 minutes, p&lt;0.001), whereas peak CPK levels did not differ significantly between the groups. At 30 days, the incidence of major adverse cardiovascular events plus congestive heart failure was significantly lower in Group A than in Group B (4.1% vs. 13.3%, log-rank p=0.01). These findings suggest that optimal post-PCI TIMI 3 flow is associated with faster enzymatic washout and better short-term outcomes, and that time to peak CPK may provide complementary information regarding reperfusion quality in STEMI patients.</p>

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Delayed CPK peak after primary PCI in STEMI: marker of reperfusion quality and short-term outcomes

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月12日

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  • Eitaro Umehara,
  • Yutaro Nagase,
  • Shunpei Yao,
  • Kana Nagasawa,
  • Noriaki Kobayashi,
  • Yoshiki Asakura,
  • Atsushi Miyajima,
  • Naoto Inoue,
  • Arata Hagikura,
  • Takanori Kusuyama,
  • Hidetaka Iida

摘要

Time to peak creatine phosphokinase (CPK) has historically been used as a surrogate marker of reperfusion in ST-elevation myocardial infarction (STEMI), but its significance in the contemporary primary percutaneous coronary intervention (PCI) era remains uncertain. We retrospectively analyzed 239 consecutive STEMI patients who underwent primary PCI at Tsukazaki Hospital between January 2021 and December 2024. Patients were categorized according to final post-PCI TIMI flow: TIMI 3 (Group A, n=194) and non-TIMI 3 (Group B, n=45). The median time to peak CPK was significantly shorter in Group A compared with Group B (365.0 vs. 684.0 minutes, p<0.001), whereas peak CPK levels did not differ significantly between the groups. At 30 days, the incidence of major adverse cardiovascular events plus congestive heart failure was significantly lower in Group A than in Group B (4.1% vs. 13.3%, log-rank p=0.01). These findings suggest that optimal post-PCI TIMI 3 flow is associated with faster enzymatic washout and better short-term outcomes, and that time to peak CPK may provide complementary information regarding reperfusion quality in STEMI patients.