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

Delayed CPK peak after primary PCI in STEMI: marker of reperfusion quality and short-term outcomes | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Delayed CPK peak after primary PCI in STEMI: marker of reperfusion quality and short-term outcomes Eitaro Umehara, YUtaro Nagase, Shunpei Yao, Kana Nagasawa, Yoshiaki Asakura, and 6 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7558939/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract 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 (330 vs. 517 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 serve as a simple and clinically useful adjunctive marker of reperfusion quality in STEMI patients. Cardiac & Cardiovascular Systems TIMI flow CPK peak out time primary PCI outcomes Biomarker kinetics Figures Figure 1 Figure 2 Figure 3 Introduction Prompt and effective reperfusion is essential for improving clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) has become the standard therapy to restore coronary flow. However, despite successful angiographic results, truly effective reperfusion is not always achieved, because residual microvascular dysfunction and distal embolization can compromise myocardial salvage 1) . Biomarkers such as creatine phosphokinase (CPK) and cardiac troponins have traditionally been used to estimate infarct size. Among them, the timing of peak CPK has served as a surrogate marker for the reperfusion process. Earlier peaks are generally interpreted as reflecting more successful reperfusion and faster washout of necrotic enzymes, while delayed peaks may suggest impaired microvascular flow or ongoing myocardial injury 2) . Most studies addressing the clinical implications of time to CPK peak were conducted during the fibrinolytic era, and evidence in the contemporary PCI era remains limited 3) . In particular, procedural factors such as distal embolization and side branch occlusion can affect coronary flow and influence biomarker kinetics independently of infarct size 4)−6) . The Thrombolysis in Myocardial Infarction (TIMI) flow grade is a widely accepted angiographic measure of coronary reperfusion, with TIMI 3 flow representing optimal restoration of epicardial flow 7) . Whether differences in post-PCI TIMI flow grades are associated with distinct patterns in CPK kinetics has not been thoroughly investigated in the current practice of primary PCI. Therefore, in the present study, we evaluated the relationship between final post-PCI TIMI flow grade and time to CPK peak in patients with STEMI undergoing emergency PCI at our institution. We further examined whether this biomarker-based parameter could provide additional clinical information beyond angiographic endpoints, including its association with short-term adverse outcomes. Methods Study Population We conducted a retrospective, single-center study including patients with STEMI who underwent primary PCI between January 1, 2021, and December 31, 2024, at Tsukazaki Hospital. STEMI was diagnosed on the basis of ( 1 ) chest pain and/or discomfort, ( 2 ) ST-segment elevation of ≥ 0.1 mV in two or more limb leads, ≥ 0.2 mV in two or more precordial leads, or new left bundle branch block, and ( 3 ) elevated serum troponin I above the upper limit of normal. Among 544 consecutive patients who underwent emergent PCI, 239 were included after applying the following exclusion criteria: unstable angina, angina pectoris, or non-STEMI (n = 213); pre-procedural cardiogenic shock or cardiac arrest (n = 54); planned coronary artery bypass grafting (n = 11); delayed presentation (> 24 hours) or unknown symptom onset (n = 26); periprocedural pulseless electrical activity or ventricular fibrillation (n = 3); acute stent thrombosis after primary PCI for STEMI (n = 1); and STEMI in a saphenous vein graft (n = 1). Of the 239 patients included, post-PCI TIMI flow was dichotomized into two groups: TIMI 3 (Group A, n = 194) and non-TIMI 3 (Group B, n = 45) (Fig. 1 ). Data Collection Baseline demographic characteristics, cardiovascular risk factors, medical history, and pre-admission medication use were extracted from electronic medical records. Procedural information, including the culprit vessel, use of an intra-aortic balloon pump (IABP), and occurrence of distal embolism, was also collected. Laboratory data obtained at admission included CPK, CK-MB, troponin I, and B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-pro BNP). For patients with BNP data only, NT-pro BNP values were estimated using the Ishihara conversion formula, which incorporates body mass index (BMI) and estimated glomerular filtration rate (eGFR) 8) . Pre-procedural and post-procedural TIMI flow grades were assessed by experienced interventional cardiologists blinded to patient outcomes and not involved in the index PCI procedure. Distal embolism was defined as slow- or no-reflow phenomena during PCI requiring intracoronary administration of vasodilators (e.g., nicorandil or nitroprusside). Side branch occlusion was defined as complete loss of flow in a side branch ≥ 1.5 mm in diameter on the final angiographic assessment. Serial CPK levels were measured every 3 hours post-PCI until the peak was confirmed, followed by measurements every 12 hours. Time to peak CPK was recorded as the interval (in minutes) from the end of the PCI procedure to the highest recorded CPK level. Statistical Analysis Statistical analyses were performed using EZR (Easy R), a graphical user interface for R. Continuous variables were tested for normality using the Shapiro–Wilk test. Normally distributed variables were expressed as mean ± standard deviation (SD) and compared with the Student’s t-test, while non-normally distributed variables were presented as median with interquartile range (IQR) and compared using the Mann–Whitney U test. Categorical variables were expressed as numbers (percentages) and compared using the chi-square test or Fisher’s exact test. For comparisons involving more than two categories, the Kruskal–Wallis test was used. Cumulative 30-day incidence of major adverse cardiovascular events (MACE) plus congestive heart failure (CHF) was evaluated using the Kaplan–Meier method, and survival curves were compared between groups using the log-rank test. A two-sided p-value < 0.05 was considered statistically significant. Results Baseline characteristics and procedural findings A total of 239 STEMI patients were included, of whom 194 (81.2%) achieved post-PCI TIMI 3 flow (Group A) and 45 (18.8%) had TIMI 1–2 flow (Group B). Patients in Group A had a lower prevalence of hypertension compared with Group B (70.7% vs. 87.2%, p = 0.033) (Table 1 ) and were less likely to have received angiotensin receptor neprilysin inhibitors before admission (1.5% vs. 8.9%, p = 0.025) (Table 2 ). Triglyceride levels on admission were significantly higher in Group A than in Group B (median 147.5 mg/dL vs. 116.0 mg/dL, p = 0.046) (Table 1 ). Table 1 Baseline demographic and clinical characteristics according to post-PCI TIMI flow grade All Patients Group A (TIMI 3) Group B (non-TIMI 3) p-value (n = 239) (n = 194) (n = 45) Per Patient Age, yrs 72.0 (61.0–81.0) 72.0 (61.0–81.0) 73.0 (62.0–82.0) 0.360 Male 180 (75.3) 146 (75.3) 34 (75.6) 1.000 Body weight, kg 64.7 ± 13.2 65.0 ± 13.4 63.4 ± 12.4 0.470 BMI, kg/m 2 24.3 (21.8–26.7) 24.6 (21.8–26.7) 23.4 (21.9–26.4) 0.435 Hypertension 177 (74.1) 138 (71.1) 39 (86.7) 0.037 Diabetes mellitus 83 (34.7) 67 (34.5) 16 (35.6) 1.000 Dyslipidemia 168 (70.3) 139 (71.6) 29 (64.4) 0.367 Smoking history 151 (63.2) 123 (63.4) 28 (62.2) 0.866 Dialysis 6 (2.5) 5 (2.6) 1 (2.2) 1.000 Myocardial Infarction 44 (18.4) 34 (17.5) 10 (22.2) 0.522 Past PCI 31 (13.0) 22 (11.3) 9 (20.0) 0.138 Past CABG 4 (1.7) 3 (1.5) 1 (2.2) 0.568 Heart failure history 20 (8.4) 14 (7.2) 6 (13.3) 0.228 CKD 111 (46.4) 85 (43.8) 26 (57.8) 0.099 PAD/AAA 6 (2.5) 3 (1.5) 3 (6.7) 0.083 Laboratory data NT-pro BNP, pg/mL* 199.1 (59.9–719.2) 195.5 (65.6–684.5) 227.0 (56.4–1384.3) 0.714 HbA1c, % 6.1 (5.8–6.8) 6.1 (5.8–6.8) 6.1 (5.7–6.8) 0.803 Total cholesterol, mg/dL 203.6 ± 44.0 204.7 ± 44.6 198.2 ± 41.4 0.386 LDL-C, mg/dL 126.8 ± 37.3 127.8 ± 37.7 122.8 ± 35.4 0.425 HDL-C, mg/dL 51.0 (43.0–61.0) 51.0 (43.0–61.0) 50.0 (44.8–62.8) 0.617 Triglyceride, mg/dL 141.0 (90.5–209.5) 147.5 (92.0–218.3) 116.0 (75.0–175.0) 0.071 Troponin I, pg/mL 211.7 (35.3–2545.6) 218.3 (38.3–2528.9) 211.7 (15.7–2864.6) 0.641 eGFR, mL/min/1.73 m² 62.9 (48.7–75.8) 64.5 (50.6–75.8) 53.1 (41.6–76.1) 0.177 Values are presented as mean ± SD for normally distributed variables, median (IQR) for non-normally distributed variables, and n (%) for categorical variables. NT-pro BNP values were converted from BNP using the Ishihara formula, which accounts for BMI and eGFR for log-transformed conversion between BNP and NT-pro BNP values. The non-TIMI 3 group showed a higher prevalence of hypertension and lower triglyceride levels compared with the TIMI 3 group. Table 2 Pre-admission medication use according to post-PCI TIMI flow grade All Patients Group A (TIMI 3) Group B (non-TIMI 3) p-value (n = 239) (n = 194) (n = 45) Prehospital medications ACEI/ARB 77 (32.2) 63 (32.5) 14 (31.1) 1.000 ARNI 7 (2.9) 3 (1.5) 4 (8.9) 0.025 Aspirin 32 (13.4) 22 (11.3) 10 (22.2) 0.085 Diuretic 12 (5.0) 10 (5.2) 2 (4.4) 1.000 DPP-4 39 (16.3) 31(16.0) 8 (17.8) 0.823 GLP-1 4 (1.7) 2 (1.0) 2 (4.4) 0.162 Insulin 3 (1.3) 3 (1.5) 0 (0.0) 1.000 MRA 7 (2.9) 6 (3.1) 1 (2.2) 1.000 OAC 4 (1.7) 4 (2.1) 0 (0.0) 1.000 SGLT2 20 (8.4) 13 (6.7) 7 (15.6) 0.070 Statin 66 (27.6) 54 (27.8) 12 (26.7) 1.000 Thienopyridine 13 (5.4) 11 (5.7) 2 (4.4) 1.000 β-blocker 32 (13.4) 27 (13.9) 5 (11.1) 0.809 Values are presented as n (%). The use of angiotensin receptor neprilysin inhibitors (ARNI) was significantly higher in the non-TIMI 3 group compared with the TIMI 3 group, while the use of other medications was comparable between groups. Abbreviations: ACEI = angiotensin-converting enzyme inhibitor; ARB = angiotensin receptor blocker; ARNI = angiotensin receptor neprilysin inhibitor; DPP-4 = dipeptidyl peptidase-4 inhibitor; GLP-1 = glucagon-like peptide-1 receptor agonist; MRA = mineralocorticoid receptor antagonist; OAC = oral anticoagulant; SGLT-2 = sodium-glucose cotransporter 2 inhibitor. Procedurally, Group A had a lower rate of intra-aortic balloon pump (IABP) use (4.6% vs. 31.1%, p < 0.001) and distal embolization (22.7% vs. 77.8%, p < 0.001), with a lower trend in side branch occlusion (5.2% vs. 13.3%, p = 0.093). Postprocedural heart rate was significantly higher in Group A compared with Group B (80 bpm vs. 71 bpm, p = 0.011) (Table 3 ). Table 3 Procedural characteristics and angiographic findings according to post-PCI TIMI flow grade All Patients Group A (TIMI 3) Group B (non-TIMI 3) p-value (n = 239) (n = 194) (n = 45) PCI lesions Left main coronary artery 3 (1.3) 3 (1.5) 0 (0.0) 1.000 Left anterior descending artery 116 (48.5) 96 (49.5) 20 (44.4) 0.62 Left circumflex artery 43 (18.0) 37 (19.1) 6 (13.3) 0.518 Right coronary artery 86 (36.0) 66 (33.5) 21 (46.7) 0.121 Lesion length, mm 28.0 (20.0–42.0) 28.0 (20.0–41.0) 28.0 (23.0–51.0) 0.343 Operation time, min 66.5 (50.8–89.9) 63.1 (49.4–85.3) 83.9 (69.8–110.9) < 0.001 Pre-TIMI flow grade 0 159 (66.3) 125 (64.4) 34 (75.6) 0.113 1 31 (13.0) 25 (12.9) 6 (13.3) 2 40 (16.7) 36 (18.6) 4 (8.9) 3 9 (3.8) 8 (4.1) 1 (2.2) Final TIMI flow grade 0 0 (0) 0 (0) 0 (0) < 0.001 1 6(2.5) 0 (0) 6 (13.3) 2 39 (16.3) 0 (0) 39 (86.7) 3 194 (81.2) 194 (100) 0 (0) Device and technique IABP 23 (9.6) 9 (4.6) 14 (31.1) < 0.001 Rotablator 4 (1.7) 4 (2.1) 0 (0.0) 1.000 IVL 1 (0.4) 1 (0.5) 0 (0.0) 1.000 DCB 25 (10.5) 18 (9.3) 7 (15.6) 0.276 Distal Protection 6 (2.5) 6 (3.1) 0 (0.0) 0.597 Procedual event Distal embolism 78 (32.6) 43 (22.2) 35 (77.8) < 0.001 Side branch occlusion 17 (7.1) 11 (5.7) 6 (13.3) 0.101 Onset to visit, Door to balloon time < 6hr 176 (73.6) 140 (72.2) 36 (80.8) 0.503 < 12hr 42 (17.6) 37 (19.1) 5 (11.1) < 24hr 21 (8.8) 17 (8.7) 4 (8.9) Door to Balloon time, min 62.0 (50.0–81.0) 62.0 (50.0–80.0) 63.0 (49.0–102.0) 0.366 Heamodynamic State Preoperative systolic blood pressure, mmHg 158.0 (133.5–174.5) 159.0 (135.0–176.5) 153.0 (128.0–166.0) 0.220 Preoperative diastolic blood pressure, mmHg 91.7 ± 20.1 92.1 ± 20.3 89.6 ± 19.6 0.456 Preoperative heart rate, bpm 75.0 (63.0–91.0) 75.0 (65.0–92.0) 73.0 (62.0–83.0) 0.443 Postoperative systolic blood pressure, mmHg 137.6 ± 25.3 138.6 ± 26.1 133.0 ± 21.2 0.182 Postoperative diastolic bllod pressure, mmHg 81.4 ± 14.5 81.9 ± 14.5 79.3 ± 14.8 0.283 Postoperative heart rate, bpm 80.0 (69.0–91.0) 80.5 (71.0–91.0) 71.0 (64.0–88.0) 0.010 Values are presented as mean ± SD, median (IQR), or n (%). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. Patients in Group B had significantly higher rates of intra-aortic balloon pump (IABP) use and distal embolism compared with Group A, while other procedural and angiographic variables were generally comparable between groups. Abbreviations: IABP = intra-aortic balloon pump; Rota = rotational atherectomy; IVL = intravascular lithotripsy; DCB = drug-coated balloon. Time to peak CPK and peak CPK levels The median time to peak CPK was significantly shorter in Group A compared with Group B (330 [219–531] min vs. 517 [259–808] min, p < 0.001) (Table 4 , Fig. 2 ). Table 4 Comparison of post-PCI creatine phosphokinase (CPK) kinetics according to final TIMI flow grade All Patients Group A (TIMI 3) Group B (non-TIMI 3) p-value (n = 239) (n = 194) (n = 45) CPK peak out time, min 346.5 (225.0–346.5) 330 (219.3–530.5) 517.0 (258.5–807.8) < 0.001 Peak CPK, IU/L 2282.0 (1233.5–3921.5) 2164.0 (1148.8–3662.8) 2542.0 (1665.0–5303.0) 0.058 Values are presented as median (IQR). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. The time to peak CPK was significantly longer in Group B compared with Group A, while peak CPK levels did not differ significantly between the groups. Abbreviations: CPK = creatine phosphokinase; TIMI = Thrombolysis in Myocardial Infarction; PCI = percutaneous coronary intervention; IQR = interquartile range. In contrast, peak CPK levels were not significantly different between Group A and Group B (2164 [1149–3663] IU/L vs. 2542 [1665–5303] IU/L, p = 0.058). Thirty-day outcomes At 30 days, the cumulative incidence of MACE plus congestive heart failure was significantly lower in Group A compared with Group B (4.1%, 8/194 vs. 13.3%, 6/45) (Table 5 ). Kaplan–Meier survival analysis showed a significantly higher event-free survival rate in Group A (log-rank p = 0.01) (Fig. 3 ). Table 5 Thirty-day clinical outcomes according to post-PCI TIMI flow grade Group A (TIMI 3) Group B (non-TIMI 3) p-value (n = 194) (n = 45) 30-day MACE + CHF events, % 8 (4.1) 6 (13.3) 0.01 (Log-rank) Values are presented as n (%). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. The cumulative incidence of major adverse cardiovascular events (MACCE) plus congestive heart failure (CHF) at 30 days was significantly higher in Group B compared with Group A. Abbreviations: TIMI = Thrombolysis in Myocardial Infarction; PCI = percutaneous coronary intervention; MACE = major adverse cardiovascular events; CHF = congestive heart failure. Discussion Achieving TIMI 3 flow has been established as the primary goal of primary PCI in STEMI patients, as it is strongly associated with improved myocardial salvage and clinical outcomes 9)−11) . In the present study, we demonstrated that STEMI patients with suboptimal post-PCI flow (TIMI 1–2) experienced a significant delay in the time to CPK peak compared with those who achieved TIMI 3 flow. This finding suggests that CPK peak timing may serve as a simple and dynamic biomarker of reperfusion quality in the contemporary PCI era. While TIMI 3 flow is widely accepted as an angiographic endpoint, it does not always reflect microvascular integrity. No-reflow and distal embolization can occur even in patients with angiographic TIMI 3 flow, and these phenomena are strongly linked to adverse outcomes 12) . The timing of CPK peak may therefore complement angiographic assessment by providing information on microvascular reperfusion at the tissue level. In our study, distal embolism was markedly more frequent in the non-TIMI 3 group, supporting its role as a major mechanism of impaired washout and delayed CPK peak. The higher rate of IABP use in this group further indicates greater hemodynamic compromise, consistent with more extensive myocardial damage. Moreover, longer procedural times and lower postoperative heart rates in the non-TIMI 3 group may reflect procedural complexity and impaired myocardial recovery, although their direct effects on biomarker kinetics remain less certain. Our observation that peak CPK values were not significantly different between groups supports the notion that the timing, rather than the absolute magnitude, of enzymatic release may better capture the adequacy of reperfusion. These results support the concept that enzymatic biomarker kinetics are determined not only by infarct size but also by the quality of myocardial reperfusion 2) . Importantly, our study also showed that patients with non-TIMI 3 flow had a significantly higher incidence of 30-day MACE plus congestive heart failure. This clinical validation underscores the relevance of CPK kinetics not only as a biological surrogate but also as a prognostic marker. Identifying patients with delayed enzymatic washout could help clinicians recognize those at risk of incomplete reperfusion, potentially prompting closer monitoring or adjunctive therapy. Previous studies in the PCI era have also examined enzymatic biomarker kinetics. Shibahashi et al. demonstrated that delayed balloon-to-peak CK-MB time was prognostically relevant even after successful angiographic reperfusion 14) , whereas Katayama et al. associated delayed CK-MB peak with impaired left ventricular recovery in patients achieving TIMI 3 flow 15) . Elakabawi et al. identified predictors of suboptimal angiographic reperfusion but did not address biomarker kinetics 16) . In contrast, our study used total CPK rather than CK-MB, defined peak timing from the end of PCI, directly compared TIMI 3 versus non-TIMI 3 flow, and assessed 30-day outcomes. Taken together, these findings extend prior work by showing that delayed CPK peak is closely linked to suboptimal reperfusion and adverse short-term prognosis in contemporary STEMI care. Because serial CPK measurement is inexpensive and widely available, it may serve as a simple bedside tool to complement angiography where advanced imaging is not feasible. Limitation This study has several limitations. First, it was a retrospective, single-center study with a limited sample size, which may restrict the generalizability of our findings. Second, although CPK levels were measured systematically with frequent early sampling, variability in sampling intervals might have affected the precise determination of peak values. Third, both time to peak CPK and post-PCI TIMI flow were used as surrogate markers of reperfusion quality; however, they may not fully reflect microvascular integrity, as advanced imaging techniques were not employed. Fourth, clinical outcomes were assessed only up to 30 days, and the longer-term prognostic significance of delayed CPK peak remains to be determined. Conclusion In STEMI patients undergoing primary PCI, suboptimal post-PCI TIMI flow was associated with delayed time to CPK peak and higher 30-day event rates. Monitoring the time course of CPK release may provide a simple and clinically meaningful adjunct to angiographic assessment, offering additional insight into the effectiveness of reperfusion. Prospective studies are warranted to confirm the prognostic utility of CPK peak timing in contemporary STEMI care. Declarations Ethics approval: This study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed by the Tsukazaki Hospital Ethics Committee, which determined that formal approval could be waived due to the retrospective design. Consent to participate and publish: Written informed consent was obtained from all patients for participation and publication of anonymized data. Acknowledge: We thank the clinical staff of the Department of Cardiology, Tsukazaki Hospital, for their dedicated patient care and assistance with data collection. We also acknowledge the use of EZR (Saitama Medical Center, Jichii Medical University, Saitama, Japan) for statistical analysis and thank Dr. Yoshinobu Kanda for its development and distribution. We further thank ChatGPT (OpenAI) for its assistance in refining the language and structure of this manuscript. Ethics, Consent to Participate, and Consent to Publish declarations: not applicable. References Kakavand H, Aghakouchakzadeh M, Coons JC, Talasaz AH (2021) Pharmacologic prevention of myocardial ischemia–reperfusion injury in patients with acute coronary syndrome undergoing percutaneous coronary intervention. J Cardiovasc Pharmacol 77(4):430–449 Gore JM, Roberts R, Ball SP, Montero A, Goldberg RJ, Dalen JE (1987) Peak creatine kinase as a measure of effectiveness of thrombolytic therapy in acute myocardial infarction. Am J Cardiol 59(15):1234–1238 Zabel M, Hohnloser SH, Köster W, Prinz M, Kasper W, Just H (1993) Analysis of creatine kinase, CK-MB, myoglobin, and troponin T time-activity curves for early assessment of coronary artery reperfusion after intravenous thrombolysis. Circulation 87(5):1542–1550 De Haeck J, Verouden NJW, Henriques JPS, Koch KT (2009) Current status of distal embolization in percutaneous coronary intervention: mechanical and pharmacological strategies. Future Cardiol 5(4):385–402 Kirtane AJ, Gibson CM (2006) Distal embolization of thrombus in acute myocardial infarction. Am J Med 119(12):e1–2 Strepkos D, Alexandrou M, Mutlu D, Carvalho PEP, Ser OS, Jalli S (2025) Impact of side branch occlusion on patient outcomes after bifurcation percutaneous coronary intervention. Catheter Cardiovasc Interv 105(5):1142–1148 TIMI Study Group (1985) The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. N Engl J Med 312:932–936 Satomi Ishihara S, Hiramitsu K, Kanaoka M, Taki H, Nakagawa T, Ueda et al (2022) New conversion formula between B-type natriuretic peptide and Nterminal proBtype natriuretic peptide: analysis from a multicenter study. Circ J 86(12):2010–2018 Caixeta A, Lansky AJ, Mehran R, Stone GW, Witzenbichler B, Parise H et al (2013) Predictors of suboptimal TIMI flow after primary angioplasty for acute myocardial infarction: results from the HORIZONS-AMI trial. EuroIntervention 9(2):220–227 Mehta RH, Ou FS, Peterson ED, Shaw RE, Hillegass WB, Rumsfeld JS et al (2009) Clinical significance of post-procedural TIMI flow in patients with cardiogenic shock undergoing primary percutaneous coronary intervention. JACC Cardiovasc Interv 2(1):56–64 Ndrepepa G, Mehilli J, Schulz S, Iijima R, Keta D, Byrne RA et al (2008) Prognostic significance of epicardial blood flow before and after percutaneous coronary intervention in patients with acute coronary syndromes. J Am Coll Cardiol 52(7):512–517 Niccoli G, Burzotta F, Galiuto L, Crea F (2009) Myocardial no-reflow in humans. J Am Coll Cardiol 54(4):281–292 Stone GW, Webb J, Cox DA et al (2005) Distal microcirculatory protection during percutaneous coronary intervention in acute ST-segment elevation myocardial infarction: a randomized controlled trial. JAMA 293(9):1063–1072 Shibahashi E, Kawakami R, Fukushima N, Yamashita T, Hasegawa Y, Suzuki M et al (2025) Prognostic significance of time between balloon and peak CK-MB in AMI patients undergoing primary PCI. JACC Asia 5(5):650–659 Katayama T, Nakashima H, Takagi C, Yamamoto T, Kobayashi Y, Tanaka S et al (2005) Prognostic significance of time-delay to peak creatine kinase after direct percutaneous coronary intervention in acute myocardial infarction patients. Int Heart J 46(5):771–781 Elakabawi K, Huang X, Shar SA, Al-Masry H, Smith J, Johnson L et al (2020) Predictors of suboptimal coronary blood flow after primary angioplasty and its implications on short-term outcomes in patients with acute anterior STEMI. BMC Cardiovasc Disord 20(1):391 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7558939","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":511553247,"identity":"53f0b7d1-4b84-4aa2-b0fe-4175b811d7dc","order_by":0,"name":"Eitaro Umehara","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA+UlEQVRIie3PsQrCMBQF0MgDXYSuZvAfCoWAUNoPcWkJ6KJ7hw4pgk7ql7h2rgR0CXatOKi4OgiC4CLGogWHRtwEc6HlDu9wCUI6Or8YKFr98bPlV4kSNSlMTjoPwtQEvROeVyUxasb8HATIn43GsoSpMxtxuRLa7TKCBwBYCOTHYkWxWGxoLHxJFp0+KyEmB4SjoSRZz8SsuqEkkaTCeClxOcA1J9ujdWW3FSXpXk1MgOpzpU5kSRySfVhpcCAtJhpWLHqkFU2oRzK54ineYkznhzUL7Ga8FNaaXRyXpN397hTapeQ1VjQ/v/TU5+9xvznW0dHR+Y/cAYJ6YgW4Qy4qAAAAAElFTkSuQmCC","orcid":"https://orcid.org/0009-0003-1931-0236","institution":"Tsukazaki Hospital","correspondingAuthor":true,"prefix":"","firstName":"Eitaro","middleName":"","lastName":"Umehara","suffix":""},{"id":511553248,"identity":"7212bbc4-b172-4915-b1b4-e3757e4ecbf7","order_by":1,"name":"YUtaro Nagase","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"YUtaro","middleName":"","lastName":"Nagase","suffix":""},{"id":511553249,"identity":"fec83bb5-01c9-447f-b5a5-e5d829cfc6fe","order_by":2,"name":"Shunpei Yao","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Shunpei","middleName":"","lastName":"Yao","suffix":""},{"id":511553250,"identity":"9116c7a1-24c0-443d-a3d9-4c3d19427ab1","order_by":3,"name":"Kana Nagasawa","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Kana","middleName":"","lastName":"Nagasawa","suffix":""},{"id":511553251,"identity":"d90c1514-7d2b-4635-b84c-e05f84527c43","order_by":4,"name":"Yoshiaki Asakura","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Yoshiaki","middleName":"","lastName":"Asakura","suffix":""},{"id":511553252,"identity":"c25c1e88-f52b-4b0c-817a-0bc873433397","order_by":5,"name":"Noraki Kobayashi","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Noraki","middleName":"","lastName":"Kobayashi","suffix":""},{"id":511553253,"identity":"627490b9-6f4d-448c-900f-4bf449b24812","order_by":6,"name":"Atsushi Miyajima","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Atsushi","middleName":"","lastName":"Miyajima","suffix":""},{"id":511553254,"identity":"0063b29b-383f-456c-891d-1ab5bdaecfc2","order_by":7,"name":"Naoto Inoue","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Naoto","middleName":"","lastName":"Inoue","suffix":""},{"id":511553255,"identity":"82ea86ad-657f-4402-8e07-eeadcb7c5f35","order_by":8,"name":"Arata Hagikura","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Arata","middleName":"","lastName":"Hagikura","suffix":""},{"id":511553256,"identity":"e69d7436-9dc8-43c0-af87-cd769eb0e594","order_by":9,"name":"Takanori Kusuyama","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Takanori","middleName":"","lastName":"Kusuyama","suffix":""},{"id":511553257,"identity":"3267cb93-1061-43ae-b1b5-cf53a989febe","order_by":10,"name":"Hidetaka Iida","email":"","orcid":"","institution":"Tsukazaki Hospital","correspondingAuthor":false,"prefix":"","firstName":"Hidetaka","middleName":"","lastName":"Iida","suffix":""}],"badges":[],"createdAt":"2025-09-08 01:11:57","currentVersionCode":1,"declarations":{"humanSubjects":false,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":false,"humanSubjectConsent":false,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":false,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-7558939/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7558939/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91077835,"identity":"85033465-2635-4cf6-abec-ffcf1b12bb7c","added_by":"auto","created_at":"2025-09-11 11:16:48","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":215860,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eStudy enrollment and exclusion\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFlow chart showing the enrollment of STEMI patients undergoing primary PCI between January 1, 2021, and December 31, 2024. Of 542 patients initially screened, 303 were excluded according to predefined criteria, including unstable angina, non-ST elevation myocardial infarction, pre-procedural cardiac arrest, delayed presentation, and other conditions. The final study population included 239 patients, categorized into Group A (TIMI 3 flow, n = 194) and Group B (non-TIMI 3 flow, n = 45) according to final post-PCI TIMI flow grade.\u003c/p\u003e","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-7558939/v1/c086859332eb390c4540a158.png"},{"id":91077836,"identity":"223324f6-2867-441f-bec0-7be13e657d91","added_by":"auto","created_at":"2025-09-11 11:16:48","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":136223,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eTime to peak CPK according to post-PCI TIMI flow\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eBox-and-whisker plot showing the distribution of time to peak creatine phosphokinase (CPK) in patients with post-PCI TIMI 3 flow and non-TIMI 3 flow. Median time to peak CPK was significantly shorter in the TIMI 3 group compared with the non-TIMI 3 group (330 min [95% CI: 219–531] vs. 517 min [95% CI: 259–808], p \u0026lt; 0.001, Mann–Whitney U test).\u003c/p\u003e","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-7558939/v1/5c4e5fa73805525371e17d8e.png"},{"id":91077837,"identity":"6f257b53-6ce3-4455-bfe9-e12fa74a84d1","added_by":"auto","created_at":"2025-09-11 11:16:48","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":209622,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eKaplan–Meier curves for 30-day cumulative incidence of MACE plus congestive heart failure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eKaplan–Meier curves showing the 30-day cumulative incidence of major adverse cardiovascular events (MACE) plus congestive heart failure (CHF), stratified by final post-PCI TIMI flow grade (TIMI 3 vs. non-TIMI 3). Event-free survival was significantly lower in the non-TIMI 3 group compared with the TIMI 3 group (log-rank p = 0.01).\u003c/p\u003e","description":"","filename":"Figure3.png","url":"https://assets-eu.researchsquare.com/files/rs-7558939/v1/bcfe8b42bf822bead66566ee.png"},{"id":91080217,"identity":"39cd332b-8484-46eb-be45-21cbf18334d3","added_by":"auto","created_at":"2025-09-11 11:32:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2003039,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7558939/v1/b42ab149-d283-4253-98b2-2b365f38de3e.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eDelayed CPK peak after primary PCI in STEMI: marker of reperfusion quality and short-term outcomes\u003c/p\u003e","fulltext":[{"header":"Introduction","content":"\u003cp\u003ePrompt and effective reperfusion is essential for improving clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) has become the standard therapy to restore coronary flow. However, despite successful angiographic results, truly effective reperfusion is not always achieved, because residual microvascular dysfunction and distal embolization can compromise myocardial salvage\u003csup\u003e1)\u003c/sup\u003e. Biomarkers such as creatine phosphokinase (CPK) and cardiac troponins have traditionally been used to estimate infarct size. Among them, the timing of peak CPK has served as a surrogate marker for the reperfusion process. Earlier peaks are generally interpreted as reflecting more successful reperfusion and faster washout of necrotic enzymes, while delayed peaks may suggest impaired microvascular flow or ongoing myocardial injury\u003csup\u003e2)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eMost studies addressing the clinical implications of time to CPK peak were conducted during the fibrinolytic era, and evidence in the contemporary PCI era remains limited\u003csup\u003e3)\u003c/sup\u003e. In particular, procedural factors such as distal embolization and side branch occlusion can affect coronary flow and influence biomarker kinetics independently of infarct size \u003csup\u003e4)\u0026minus;6)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eThe Thrombolysis in Myocardial Infarction (TIMI) flow grade is a widely accepted angiographic measure of coronary reperfusion, with TIMI 3 flow representing optimal restoration of epicardial flow\u003csup\u003e7)\u003c/sup\u003e. Whether differences in post-PCI TIMI flow grades are associated with distinct patterns in CPK kinetics has not been thoroughly investigated in the current practice of primary PCI.\u003c/p\u003e\u003cp\u003eTherefore, in the present study, we evaluated the relationship between final post-PCI TIMI flow grade and time to CPK peak in patients with STEMI undergoing emergency PCI at our institution. We further examined whether this biomarker-based parameter could provide additional clinical information beyond angiographic endpoints, including its association with short-term adverse outcomes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eStudy Population\u003c/p\u003e\u003cp\u003eWe conducted a retrospective, single-center study including patients with STEMI who underwent primary PCI between January 1, 2021, and December 31, 2024, at Tsukazaki Hospital. STEMI was diagnosed on the basis of (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) chest pain and/or discomfort, (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e) ST-segment elevation of \u0026ge;\u0026thinsp;0.1 mV in two or more limb leads, \u0026ge;\u0026thinsp;0.2 mV in two or more precordial leads, or new left bundle branch block, and (\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e) elevated serum troponin I above the upper limit of normal. Among 544 consecutive patients who underwent emergent PCI, 239 were included after applying the following exclusion criteria: unstable angina, angina pectoris, or non-STEMI (n\u0026thinsp;=\u0026thinsp;213); pre-procedural cardiogenic shock or cardiac arrest (n\u0026thinsp;=\u0026thinsp;54); planned coronary artery bypass grafting (n\u0026thinsp;=\u0026thinsp;11); delayed presentation (\u0026gt;\u0026thinsp;24 hours) or unknown symptom onset (n\u0026thinsp;=\u0026thinsp;26); periprocedural pulseless electrical activity or ventricular fibrillation (n\u0026thinsp;=\u0026thinsp;3); acute stent thrombosis after primary PCI for STEMI (n\u0026thinsp;=\u0026thinsp;1); and STEMI in a saphenous vein graft (n\u0026thinsp;=\u0026thinsp;1). Of the 239 patients included, post-PCI TIMI flow was dichotomized into two groups: TIMI 3 (Group A, n\u0026thinsp;=\u0026thinsp;194) and non-TIMI 3 (Group B, n\u0026thinsp;=\u0026thinsp;45) (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eData Collection\u003c/p\u003e\u003cp\u003eBaseline demographic characteristics, cardiovascular risk factors, medical history, and pre-admission medication use were extracted from electronic medical records. Procedural information, including the culprit vessel, use of an intra-aortic balloon pump (IABP), and occurrence of distal embolism, was also collected. Laboratory data obtained at admission included CPK, CK-MB, troponin I, and B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-pro BNP). For patients with BNP data only, NT-pro BNP values were estimated using the Ishihara conversion formula, which incorporates body mass index (BMI) and estimated glomerular filtration rate (eGFR)\u003csup\u003e8)\u003c/sup\u003e. Pre-procedural and post-procedural TIMI flow grades were assessed by experienced interventional cardiologists blinded to patient outcomes and not involved in the index PCI procedure. Distal embolism was defined as slow- or no-reflow phenomena during PCI requiring intracoronary administration of vasodilators (e.g., nicorandil or nitroprusside). Side branch occlusion was defined as complete loss of flow in a side branch\u0026thinsp;\u0026ge;\u0026thinsp;1.5 mm in diameter on the final angiographic assessment. Serial CPK levels were measured every 3 hours post-PCI until the peak was confirmed, followed by measurements every 12 hours. Time to peak CPK was recorded as the interval (in minutes) from the end of the PCI procedure to the highest recorded CPK level.\u003c/p\u003e\u003cdiv id=\"Sec2\" class=\"Section2\"\u003e\u003ch2\u003eStatistical Analysis\u003c/h2\u003e\u003cp\u003eStatistical analyses were performed using EZR (Easy R), a graphical user interface for R. Continuous variables were tested for normality using the Shapiro\u0026ndash;Wilk test. Normally distributed variables were expressed as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;standard deviation (SD) and compared with the Student\u0026rsquo;s t-test, while non-normally distributed variables were presented as median with interquartile range (IQR) and compared using the Mann\u0026ndash;Whitney U test. Categorical variables were expressed as numbers (percentages) and compared using the chi-square test or Fisher\u0026rsquo;s exact test. For comparisons involving more than two categories, the Kruskal\u0026ndash;Wallis test was used.\u003c/p\u003e\u003cp\u003eCumulative 30-day incidence of major adverse cardiovascular events (MACE) plus congestive heart failure (CHF) was evaluated using the Kaplan\u0026ndash;Meier method, and survival curves were compared between groups using the log-rank test. A two-sided p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eBaseline characteristics and procedural findings\u003c/p\u003e\u003cp\u003eA total of 239 STEMI patients were included, of whom 194 (81.2%) achieved post-PCI TIMI 3 flow (Group A) and 45 (18.8%) had TIMI 1\u0026ndash;2 flow (Group B).\u003c/p\u003e\u003cp\u003ePatients in Group A had a lower prevalence of hypertension compared with Group B (70.7% vs. 87.2%, p\u0026thinsp;=\u0026thinsp;0.033) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) and were less likely to have received angiotensin receptor neprilysin inhibitors before admission (1.5% vs. 8.9%, p\u0026thinsp;=\u0026thinsp;0.025) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). Triglyceride levels on admission were significantly higher in Group A than in Group B (median 147.5 mg/dL vs. 116.0 mg/dL, p\u0026thinsp;=\u0026thinsp;0.046) (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eBaseline demographic and clinical characteristics according to post-PCI TIMI flow grade\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGroup A (TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eGroup B (non-TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;194)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePer Patient\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAge, yrs\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e72.0 (61.0\u0026ndash;81.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e72.0 (61.0\u0026ndash;81.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e73.0 (62.0\u0026ndash;82.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.360\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e180 (75.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e146 (75.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e34 (75.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBody weight, kg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e64.7\u0026thinsp;\u0026plusmn;\u0026thinsp;13.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e65.0\u0026thinsp;\u0026plusmn;\u0026thinsp;13.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e63.4\u0026thinsp;\u0026plusmn;\u0026thinsp;12.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.470\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eBMI, kg/m\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e24.3 (21.8\u0026ndash;26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e24.6 (21.8\u0026ndash;26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e23.4 (21.9\u0026ndash;26.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.435\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHypertension\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e177 (74.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e138 (71.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e39 (86.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.037\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiabetes mellitus\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e83 (34.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e67 (34.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e16 (35.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDyslipidemia\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e168 (70.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e139 (71.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e29 (64.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.367\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSmoking history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e151 (63.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e123 (63.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e28 (62.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.866\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDialysis\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6 (2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e5 (2.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1 (2.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMyocardial Infarction\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e44 (18.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e34 (17.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e10 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.522\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePast PCI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e31 (13.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22 (11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e9 (20.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.138\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePast CABG\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1 (2.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.568\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHeart failure history\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20 (8.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e14 (7.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.228\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eCKD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e111 (46.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e85 (43.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e26 (57.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.099\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePAD/AAA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6 (2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e3 (6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.083\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eLaboratory data\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNT-pro BNP, pg/mL*\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e199.1 (59.9\u0026ndash;719.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e195.5 (65.6\u0026ndash;684.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e227.0 (56.4\u0026ndash;1384.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.714\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHbA1c, %\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e6.1 (5.8\u0026ndash;6.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6.1 (5.8\u0026ndash;6.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e6.1 (5.7\u0026ndash;6.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.803\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTotal cholesterol, mg/dL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e203.6\u0026thinsp;\u0026plusmn;\u0026thinsp;44.0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e204.7\u0026thinsp;\u0026plusmn;\u0026thinsp;44.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e198.2\u0026thinsp;\u0026plusmn;\u0026thinsp;41.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.386\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLDL-C, mg/dL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e126.8\u0026thinsp;\u0026plusmn;\u0026thinsp;37.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e127.8\u0026thinsp;\u0026plusmn;\u0026thinsp;37.7\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e122.8\u0026thinsp;\u0026plusmn;\u0026thinsp;35.4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.425\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHDL-C, mg/dL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e51.0 (43.0\u0026ndash;61.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e51.0 (43.0\u0026ndash;61.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e50.0 (44.8\u0026ndash;62.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.617\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTriglyceride, mg/dL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e141.0 (90.5\u0026ndash;209.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e147.5 (92.0\u0026ndash;218.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e116.0 (75.0\u0026ndash;175.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.071\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eTroponin I, pg/mL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e211.7 (35.3\u0026ndash;2545.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e218.3 (38.3\u0026ndash;2528.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e211.7 (15.7\u0026ndash;2864.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.641\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eeGFR, mL/min/1.73 m\u0026sup2;\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e62.9 (48.7\u0026ndash;75.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e64.5 (50.6\u0026ndash;75.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e53.1 (41.6\u0026ndash;76.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.177\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003eValues are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD for normally distributed variables, median (IQR) for non-normally distributed variables, and n (%) for categorical variables. NT-pro BNP values were converted from BNP using the Ishihara formula, which accounts for BMI and eGFR for log-transformed conversion between BNP and NT-pro BNP values. The non-TIMI 3 group showed a higher prevalence of hypertension and lower triglyceride levels compared with the TIMI 3 group.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003ePre-admission medication use according to post-PCI TIMI flow grade\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGroup A (TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eGroup B (non-TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;194)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePrehospital medications\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eACEI/ARB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e77 (32.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e63 (32.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e14 (31.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eARNI\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (2.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e4 (8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.025\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eAspirin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e32 (13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e22 (11.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e10 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.085\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDiuretic\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12 (5.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e10 (5.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2 (4.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDPP-4\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e39 (16.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e31(16.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e8 (17.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.823\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGLP-1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e2 (1.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2 (4.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.162\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eInsulin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e3 (1.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMRA\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e7 (2.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e6 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e1 (2.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOAC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e4 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e4 (2.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSGLT2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e20 (8.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e13 (6.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e7 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.070\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eStatin\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e66 (27.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e54 (27.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e12 (26.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eThienopyridine\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e13 (5.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e11 (5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e2 (4.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eβ-blocker\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e32 (13.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e\u003cp\u003e27 (13.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e\u003cp\u003e5 (11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e\u003cp\u003e0.809\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003eValues are presented as n (%). The use of angiotensin receptor neprilysin inhibitors (ARNI) was significantly higher in the non-TIMI 3 group compared with the TIMI 3 group, while the use of other medications was comparable between groups.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003eAbbreviations: ACEI\u0026thinsp;=\u0026thinsp;angiotensin-converting enzyme inhibitor; ARB\u0026thinsp;=\u0026thinsp;angiotensin receptor blocker; ARNI\u0026thinsp;=\u0026thinsp;angiotensin receptor neprilysin inhibitor; DPP-4\u0026thinsp;=\u0026thinsp;dipeptidyl peptidase-4 inhibitor; GLP-1\u0026thinsp;=\u0026thinsp;glucagon-like peptide-1 receptor agonist; MRA\u0026thinsp;=\u0026thinsp;mineralocorticoid receptor antagonist; OAC\u0026thinsp;=\u0026thinsp;oral anticoagulant; SGLT-2\u0026thinsp;=\u0026thinsp;sodium-glucose cotransporter 2 inhibitor.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eProcedurally, Group A had a lower rate of intra-aortic balloon pump (IABP) use (4.6% vs. 31.1%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) and distal embolization (22.7% vs. 77.8%, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), with a lower trend in side branch occlusion (5.2% vs. 13.3%, p\u0026thinsp;=\u0026thinsp;0.093). Postprocedural heart rate was significantly higher in Group A compared with Group B (80 bpm vs. 71 bpm, p\u0026thinsp;=\u0026thinsp;0.011) (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eProcedural characteristics and angiographic findings according to post-PCI TIMI flow grade\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"10\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eGroup A (TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003eGroup B (non-TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;194)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003ePCI lesions\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeft main coronary artery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3 (1.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e3 (1.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeft anterior descending artery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e116 (48.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e96 (49.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e20 (44.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.62\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLeft circumflex artery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43 (18.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e37 (19.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.518\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRight coronary artery\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e86 (36.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e66 (33.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e21 (46.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.121\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eLesion length, mm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e28.0 (20.0\u0026ndash;42.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e28.0 (20.0\u0026ndash;41.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e28.0 (23.0\u0026ndash;51.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.343\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eOperation time, min\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e66.5 (50.8\u0026ndash;89.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e63.1 (49.4\u0026ndash;85.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e83.9 (69.8\u0026ndash;110.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePre-TIMI flow grade\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e159 (66.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e125 (64.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e34 (75.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.113\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e31 (13.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e25 (12.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e40 (16.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e36 (18.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4 (8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e9 (3.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e8 (4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e1 (2.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eFinal TIMI flow grade\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6(2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e39 (16.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e39 (86.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e194 (81.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e194 (100)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDevice and technique\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIABP\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e23 (9.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e9 (4.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e14 (31.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eRotablator\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e4 (1.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e4 (2.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eIVL\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1 (0.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1 (0.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e1.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDCB\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e25 (10.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e18 (9.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e7 (15.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.276\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDistal Protection\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e6 (2.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e6 (3.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e0 (0.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.597\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eProcedual event\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDistal embolism\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e78 (32.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e43 (22.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e35 (77.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSide branch occlusion\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e17 (7.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e11 (5.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.101\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eOnset to visit, Door to balloon time\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;6hr\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e176 (73.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e140 (72.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e36 (80.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.503\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;12hr\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e42 (17.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e37 (19.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e5 (11.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;24hr\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e21 (8.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e17 (8.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e4 (8.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDoor to Balloon time, min\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e62.0 (50.0\u0026ndash;81.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e62.0 (50.0\u0026ndash;80.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e63.0 (49.0\u0026ndash;102.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.366\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u003cp\u003e\u003cb\u003eHeamodynamic State\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePreoperative systolic blood pressure, mmHg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e158.0 (133.5\u0026ndash;174.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e159.0 (135.0\u0026ndash;176.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e153.0 (128.0\u0026ndash;166.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.220\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePreoperative diastolic blood pressure, mmHg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e91.7\u0026thinsp;\u0026plusmn;\u0026thinsp;20.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e92.1\u0026thinsp;\u0026plusmn;\u0026thinsp;20.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e89.6\u0026thinsp;\u0026plusmn;\u0026thinsp;19.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.456\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePreoperative heart rate, bpm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e75.0 (63.0\u0026ndash;91.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e75.0 (65.0\u0026ndash;92.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e73.0 (62.0\u0026ndash;83.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.443\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePostoperative systolic blood pressure, mmHg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e137.6\u0026thinsp;\u0026plusmn;\u0026thinsp;25.3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e138.6\u0026thinsp;\u0026plusmn;\u0026thinsp;26.1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e133.0\u0026thinsp;\u0026plusmn;\u0026thinsp;21.2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.182\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePostoperative diastolic bllod pressure, mmHg\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e81.4\u0026thinsp;\u0026plusmn;\u0026thinsp;14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e81.9\u0026thinsp;\u0026plusmn;\u0026thinsp;14.5\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e79.3\u0026thinsp;\u0026plusmn;\u0026thinsp;14.8\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.283\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePostoperative heart rate, bpm\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e80.0 (69.0\u0026ndash;91.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e80.5 (71.0\u0026ndash;91.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003e71.0 (64.0\u0026ndash;88.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003e0.010\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003eValues are presented as mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD, median (IQR), or n (%). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. Patients in Group B had significantly higher rates of intra-aortic balloon pump (IABP) use and distal embolism compared with Group A, while other procedural and angiographic variables were generally comparable between groups.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"10\"\u003eAbbreviations: IABP\u0026thinsp;=\u0026thinsp;intra-aortic balloon pump; Rota\u0026thinsp;=\u0026thinsp;rotational atherectomy; IVL\u0026thinsp;=\u0026thinsp;intravascular lithotripsy; DCB\u0026thinsp;=\u0026thinsp;drug-coated balloon.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTime to peak CPK and peak CPK levels\u003c/p\u003e\u003cp\u003eThe median time to peak CPK was significantly shorter in Group A compared with Group B (330 [219\u0026ndash;531] min vs. 517 [259\u0026ndash;808] min, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001) (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e, Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of post-PCI creatine phosphokinase (CPK) kinetics according to final TIMI flow grade\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"9\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAll Patients\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGroup A (TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003eGroup B (non-TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;239)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;194)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003e(n\u0026thinsp;=\u0026thinsp;45)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eCPK peak out time, min\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e346.5 (225.0\u0026ndash;346.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e330 (219.3\u0026ndash;530.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e517.0 (258.5\u0026ndash;807.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003ePeak CPK, IU/L\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e\u003cp\u003e2282.0 (1233.5\u0026ndash;3921.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e\u003cp\u003e2164.0 (1148.8\u0026ndash;3662.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e\u003cp\u003e2542.0 (1665.0\u0026ndash;5303.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e\u003cp\u003e0.058\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eValues are presented as median (IQR). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. The time to peak CPK was significantly longer in Group B compared with Group A, while peak CPK levels did not differ significantly between the groups.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"9\"\u003eAbbreviations: CPK\u0026thinsp;=\u0026thinsp;creatine phosphokinase; TIMI\u0026thinsp;=\u0026thinsp;Thrombolysis in Myocardial Infarction; PCI\u0026thinsp;=\u0026thinsp;percutaneous coronary intervention; IQR\u0026thinsp;=\u0026thinsp;interquartile range.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003cp\u003eIn contrast, peak CPK levels were not significantly different between Group A and Group B (2164 [1149\u0026ndash;3663] IU/L vs. 2542 [1665\u0026ndash;5303] IU/L, p\u0026thinsp;=\u0026thinsp;0.058).\u003c/p\u003e\u003cp\u003eThirty-day outcomes\u003c/p\u003e\u003cp\u003eAt 30 days, the cumulative incidence of MACE plus congestive heart failure was significantly lower in Group A compared with Group B (4.1%, 8/194 vs. 13.3%, 6/45) (Table\u0026nbsp;\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). Kaplan\u0026ndash;Meier survival analysis showed a significantly higher event-free survival rate in Group A (log-rank p\u0026thinsp;=\u0026thinsp;0.01) (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eThirty-day clinical outcomes according to post-PCI TIMI flow grade\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGroup A (TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eGroup B (non-TIMI 3)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ep-value\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;194)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003e(n\u0026thinsp;=\u0026thinsp;45)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e30-day MACE\u0026thinsp;+\u0026thinsp;CHF events, %\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8 (4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e6 (13.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.01 (Log-rank)\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eValues are presented as n (%). Group A: post-PCI TIMI 3 flow; Group B: post-PCI non-TIMI 3 flow. The cumulative incidence of major adverse cardiovascular events (MACCE) plus congestive heart failure (CHF) at 30 days was significantly higher in Group B compared with Group A.\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003eAbbreviations: TIMI\u0026thinsp;=\u0026thinsp;Thrombolysis in Myocardial Infarction; PCI\u0026thinsp;=\u0026thinsp;percutaneous coronary intervention; MACE\u0026thinsp;=\u0026thinsp;major adverse cardiovascular events; CHF\u0026thinsp;=\u0026thinsp;congestive heart failure.\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eAchieving TIMI 3 flow has been established as the primary goal of primary PCI in STEMI patients, as it is strongly associated with improved myocardial salvage and clinical outcomes\u003csup\u003e9)\u0026minus;11)\u003c/sup\u003e. In the present study, we demonstrated that STEMI patients with suboptimal post-PCI flow (TIMI 1\u0026ndash;2) experienced a significant delay in the time to CPK peak compared with those who achieved TIMI 3 flow. This finding suggests that CPK peak timing may serve as a simple and dynamic biomarker of reperfusion quality in the contemporary PCI era.\u003c/p\u003e\u003cp\u003eWhile TIMI 3 flow is widely accepted as an angiographic endpoint, it does not always reflect microvascular integrity. No-reflow and distal embolization can occur even in patients with angiographic TIMI 3 flow, and these phenomena are strongly linked to adverse outcomes\u003csup\u003e12)\u003c/sup\u003e. The timing of CPK peak may therefore complement angiographic assessment by providing information on microvascular reperfusion at the tissue level. In our study, distal embolism was markedly more frequent in the non-TIMI 3 group, supporting its role as a major mechanism of impaired washout and delayed CPK peak. The higher rate of IABP use in this group further indicates greater hemodynamic compromise, consistent with more extensive myocardial damage. Moreover, longer procedural times and lower postoperative heart rates in the non-TIMI 3 group may reflect procedural complexity and impaired myocardial recovery, although their direct effects on biomarker kinetics remain less certain. Our observation that peak CPK values were not significantly different between groups supports the notion that the timing, rather than the absolute magnitude, of enzymatic release may better capture the adequacy of reperfusion. These results support the concept that enzymatic biomarker kinetics are determined not only by infarct size but also by the quality of myocardial reperfusion\u003csup\u003e2)\u003c/sup\u003e.\u003c/p\u003e\u003cp\u003eImportantly, our study also showed that patients with non-TIMI 3 flow had a significantly higher incidence of 30-day MACE plus congestive heart failure. This clinical validation underscores the relevance of CPK kinetics not only as a biological surrogate but also as a prognostic marker. Identifying patients with delayed enzymatic washout could help clinicians recognize those at risk of incomplete reperfusion, potentially prompting closer monitoring or adjunctive therapy.\u003c/p\u003e\u003cp\u003ePrevious studies in the PCI era have also examined enzymatic biomarker kinetics. Shibahashi et al. demonstrated that delayed balloon-to-peak CK-MB time was prognostically relevant even after successful angiographic reperfusion\u003csup\u003e14)\u003c/sup\u003e, whereas Katayama et al. associated delayed CK-MB peak with impaired left ventricular recovery in patients achieving TIMI 3 flow\u003csup\u003e15)\u003c/sup\u003e. Elakabawi et al. identified predictors of suboptimal angiographic reperfusion but did not address biomarker kinetics\u003csup\u003e16)\u003c/sup\u003e. In contrast, our study used total CPK rather than CK-MB, defined peak timing from the end of PCI, directly compared TIMI 3 versus non-TIMI 3 flow, and assessed 30-day outcomes. Taken together, these findings extend prior work by showing that delayed CPK peak is closely linked to suboptimal reperfusion and adverse short-term prognosis in contemporary STEMI care. Because serial CPK measurement is inexpensive and widely available, it may serve as a simple bedside tool to complement angiography where advanced imaging is not feasible.\u003c/p\u003e\u003cp\u003eLimitation\u003c/p\u003e\u003cp\u003eThis study has several limitations.\u003c/p\u003e\u003cp\u003eFirst, it was a retrospective, single-center study with a limited sample size, which may restrict the generalizability of our findings.\u003c/p\u003e\u003cp\u003eSecond, although CPK levels were measured systematically with frequent early sampling, variability in sampling intervals might have affected the precise determination of peak values.\u003c/p\u003e\u003cp\u003eThird, both time to peak CPK and post-PCI TIMI flow were used as surrogate markers of reperfusion quality; however, they may not fully reflect microvascular integrity, as advanced imaging techniques were not employed.\u003c/p\u003e\u003cp\u003eFourth, clinical outcomes were assessed only up to 30 days, and the longer-term prognostic significance of delayed CPK peak remains to be determined.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn STEMI patients undergoing primary PCI, suboptimal post-PCI TIMI flow was associated with delayed time to CPK peak and higher 30-day event rates. Monitoring the time course of CPK release may provide a simple and clinically meaningful adjunct to angiographic assessment, offering additional insight into the effectiveness of reperfusion. Prospective studies are warranted to confirm the prognostic utility of CPK peak timing in contemporary STEMI care.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval: This study was conducted in accordance with the Declaration of Helsinki. The study protocol was reviewed by the Tsukazaki Hospital Ethics Committee, which determined that formal approval could be waived due to the retrospective design.\u003c/p\u003e\n\u003cp\u003eConsent to participate and publish: Written informed consent was obtained from all patients for participation and publication of anonymized data.\u003c/p\u003e\n\u003cp\u003eAcknowledge:\u003c/p\u003e\n\u003cp\u003eWe thank the clinical staff of the Department of Cardiology, Tsukazaki Hospital, for their dedicated patient care and assistance with data collection. We also acknowledge the use of EZR (Saitama Medical Center, Jichii Medical University, Saitama, Japan) for statistical analysis and thank Dr. Yoshinobu Kanda for its development and distribution. We further thank ChatGPT (OpenAI) for its assistance in refining the language and structure of this manuscript.\u003c/p\u003e\n\u003cp\u003eEthics, Consent to Participate, and Consent to Publish declarations: not applicable.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eKakavand H, Aghakouchakzadeh M, Coons JC, Talasaz AH (2021) Pharmacologic prevention of myocardial ischemia\u0026ndash;reperfusion injury in patients with acute coronary syndrome undergoing percutaneous coronary intervention. J Cardiovasc Pharmacol 77(4):430\u0026ndash;449\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGore JM, Roberts R, Ball SP, Montero A, Goldberg RJ, Dalen JE (1987) Peak creatine kinase as a measure of effectiveness of thrombolytic therapy in acute myocardial infarction. Am J Cardiol 59(15):1234\u0026ndash;1238\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZabel M, Hohnloser SH, K\u0026ouml;ster W, Prinz M, Kasper W, Just H (1993) Analysis of creatine kinase, CK-MB, myoglobin, and troponin T time-activity curves for early assessment of coronary artery reperfusion after intravenous thrombolysis. Circulation 87(5):1542\u0026ndash;1550\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDe Haeck J, Verouden NJW, Henriques JPS, Koch KT (2009) Current status of distal embolization in percutaneous coronary intervention: mechanical and pharmacological strategies. Future Cardiol 5(4):385\u0026ndash;402\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKirtane AJ, Gibson CM (2006) Distal embolization of thrombus in acute myocardial infarction. Am J Med 119(12):e1\u0026ndash;2\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStrepkos D, Alexandrou M, Mutlu D, Carvalho PEP, Ser OS, Jalli S (2025) Impact of side branch occlusion on patient outcomes after bifurcation percutaneous coronary intervention. Catheter Cardiovasc Interv 105(5):1142\u0026ndash;1148\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eTIMI Study Group (1985) The Thrombolysis in Myocardial Infarction (TIMI) trial. Phase I findings. N Engl J Med 312:932\u0026ndash;936\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eSatomi Ishihara S, Hiramitsu K, Kanaoka M, Taki H, Nakagawa T, Ueda et al (2022) New conversion formula between B-type natriuretic peptide and Nterminal proBtype natriuretic peptide: analysis from a multicenter study. Circ J 86(12):2010\u0026ndash;2018\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCaixeta A, Lansky AJ, Mehran R, Stone GW, Witzenbichler B, Parise H et al (2013) Predictors of suboptimal TIMI flow after primary angioplasty for acute myocardial infarction: results from the HORIZONS-AMI trial. EuroIntervention 9(2):220\u0026ndash;227\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMehta RH, Ou FS, Peterson ED, Shaw RE, Hillegass WB, Rumsfeld JS et al (2009) Clinical significance of post-procedural TIMI flow in patients with cardiogenic shock undergoing primary percutaneous coronary intervention. JACC Cardiovasc Interv 2(1):56\u0026ndash;64\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNdrepepa G, Mehilli J, Schulz S, Iijima R, Keta D, Byrne RA et al (2008) Prognostic significance of epicardial blood flow before and after percutaneous coronary intervention in patients with acute coronary syndromes. J Am Coll Cardiol 52(7):512\u0026ndash;517\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eNiccoli G, Burzotta F, Galiuto L, Crea F (2009) Myocardial no-reflow in humans. J Am Coll Cardiol 54(4):281\u0026ndash;292\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eStone GW, Webb J, Cox DA et al (2005) Distal microcirculatory protection during percutaneous coronary intervention in acute ST-segment elevation myocardial infarction: a randomized controlled trial. JAMA 293(9):1063\u0026ndash;1072\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eShibahashi E, Kawakami R, Fukushima N, Yamashita T, Hasegawa Y, Suzuki M et al (2025) Prognostic significance of time between balloon and peak CK-MB in AMI patients undergoing primary PCI. JACC Asia 5(5):650\u0026ndash;659\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKatayama T, Nakashima H, Takagi C, Yamamoto T, Kobayashi Y, Tanaka S et al (2005) Prognostic significance of time-delay to peak creatine kinase after direct percutaneous coronary intervention in acute myocardial infarction patients. Int Heart J 46(5):771\u0026ndash;781\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eElakabawi K, Huang X, Shar SA, Al-Masry H, Smith J, Johnson L et al (2020) Predictors of suboptimal coronary blood flow after primary angioplasty and its implications on short-term outcomes in patients with acute anterior STEMI. BMC Cardiovasc Disord 20(1):391\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Tsukazaki Hospital","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"TIMI flow, CPK peak out time, primary PCI outcomes, Biomarker kinetics","lastPublishedDoi":"10.21203/rs.3.rs-7558939/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7558939/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eTime 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\u0026thinsp;=\u0026thinsp;194) and non-TIMI 3 (Group B, n\u0026thinsp;=\u0026thinsp;45). The median time to peak CPK was significantly shorter in Group A compared with Group B (330 vs. 517 minutes, p\u0026thinsp;\u0026lt;\u0026thinsp;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\u0026thinsp;=\u0026thinsp;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 serve as a simple and clinically useful adjunctive marker of reperfusion quality in STEMI patients.\u003c/p\u003e","manuscriptTitle":"Delayed CPK peak after primary PCI in STEMI: marker of reperfusion quality and short-term outcomes","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-09-11 11:16:43","doi":"10.21203/rs.3.rs-7558939/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"340730be-0149-4351-9fc1-c073b74573f8","owner":[],"postedDate":"September 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":54327336,"name":"Cardiac \u0026 Cardiovascular Systems"}],"tags":[],"updatedAt":"2025-09-11T11:16:44+00:00","versionOfRecord":[],"versionCreatedAt":"2025-09-11 11:16:43","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7558939","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7558939","identity":"rs-7558939","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}