The role of baseline and post-procedural frontal plane QRS-T angles for cardiac risk assessment in patients with acute STEMI.
Ann Noninvasive Electrocardiol
; 23(5): e12558, 2018 09.
Article
em En
| MEDLINE
| ID: mdl-29873439
ABSTRACT
BACKGROUND:
To our knowledge, no study so far investigated the importance of post-procedural frontal QRS-T angle f(QRS-T) in ST segment elevation myocardial infarction (STEMI). The aim of our study was to investigate the role of baseline and post-procedural f(QRS-T) angles for determining high risk STEMI patients, and the success of reperfusion.METHODS:
A total of 248 patients with first acute STEMI that underwent primary percutaneous coronary intervention (pPCI) or thrombolytic therapy (TT) between 2013 and 2014 were included in this study. Baseline f(QRS-T) angle was defined as the angle which measured from the first ECG at the time of hospital admission. Post-procedural (QRS-T) angle was defined according to the treatment strategy as follows the angle which measured from the post-PCI ECG in patients treated with pPCI; the angle which measured from the ECG taken 90 min after onset of therapy in patients treated with TT.RESULTS:
The baseline (101.9° ± 48.0 vs. 72.1° ± 49.1, p = 0.014) and post-procedural f(QRS-T) angles (95.7° ± 48.1 vs. 58.1° ± 47.1, p = 0.002) were significantly higher in patients who developed in-hospital mortality than the patients who did not develop in-hospital mortality. Also, f(QRS-T) angle measured at 90 min was significantly lower in patients with successful thrombolysis group compared to failed thrombolysis group (53.2° ± 42.8 vs. 77.3° ± 52.9, p = 0.033), whereas baseline f(QRS-T) angle was similar between two groups (78.6° ± 53.4 vs. 78.9° ± 54.0, p = 0.976). Multivariate analysis showed that post-procedural f(QRS-T) angle ≥89.6° (odds ratio 3.541, 95% confidence interval 1.235-10.154, p = 0.019), but not baseline f(QRS-T) angle, was independent predictor of in-hospital mortality.CONCLUSION:
f(QRS-T) angle may be used as a beneficial tool for determining high risk patients in acute STEMI. Unlike previous studies, we showed for the first time that that post-procedural f(QRS-T) can predict in-hospital mortality and TT failure.Palavras-chave
Texto completo:
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Bases de dados:
MEDLINE
Assunto principal:
Terapia Trombolítica
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Eletrocardiografia
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Intervenção Coronária Percutânea
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Infarto do Miocárdio com Supradesnível do Segmento ST
Tipo de estudo:
Etiology_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Ann Noninvasive Electrocardiol
Assunto da revista:
CARDIOLOGIA
Ano de publicação:
2018
Tipo de documento:
Article
País de afiliação:
Turquia