Literature DB >> 24441394

Terminal QRS distortion and severity of coronary artery disease in ST-elevation myocardial infarction.

E M Bakirci1, K Kalkan, H Hamur, M Buyuklu, M Cetin, H Degirmenci, H Duman, Z Kucuksu, I H Tanboga, E Topal.   

Abstract

BACKGROUND: Grade 3 ischemia (G3I) is defined as ST elevation with distortion of the terminal portion of the QRS complex on electrocardiograms (ECGs) of patients with ST-segment elevation myocardial infarction (STEMI). Although the association between G3I and short- and long-term cardiovascular events is well established, its mechanism is unclear. We assessed the association between G3I on the admission ECG and SYNTAX score (SS) in patients with STEMI undergoing primary percutaneous coronary intervention. PATIENTS AND METHODS: The study population consisted of 312 patients with STEMI. Baseline ECGs of the patients were analyzed for grade of ischemia; the online latest updated version (2.11) of the SS calculator was used to determine the SS (http://www.syntaxscore.com). Patients were divided into two groups according to their grade of ischemia: grade 2 ischemia (G2I) or G3I. Also, patients were classified according to their SS as SS < 22 (low) or SS ≥ 22 (high).
RESULTS: There were 211 patients in the low SS group and 101 patients in the high SS group. G3I was present in 31.1 % (n = 97) of the study population. SS was significantly higher in patients with G3I than in patients with G2I (20.1 ± 8.8 vs. 13.7 ± 7.1, p < 0.001). G3I was significantly higher in patients with high SS (50.5 % vs. 21.8 %, p < 0.001). Multivariate logistic regression analysis revealed that G3I (p < 0.001), diabetes (p = 0.013), age (p = 0.016), and anterior MI (p = 0.011), were independent predictors of high SS.
CONCLUSION: In conclusion, G3I was independently related to high SS. We suggest that elevated SS in patients with G3I may explain the relationship between G3I and the poor outcome observed in these patients. Furthermore, the prediction of high SS by means of G3I in patients with STEMI may help determine the most appropriate revascularization method and prevent procedure failure.

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Year:  2014        PMID: 24441394     DOI: 10.1007/s00059-013-4036-3

Source DB:  PubMed          Journal:  Herz        ISSN: 0340-9937            Impact factor:   1.443


  29 in total

1.  Usefulness of the SYNTAX score to predict "no reflow" in patients treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Authors:  Michael Magro; Sjoerd T Nauta; Cihan Simsek; Eric Boersma; Elco van der Heide; Evelyn Regar; Ron T van Domburg; Felix Zijlstra; Patrick W Serruys; Robert Jan van Geuns
Journal:  Am J Cardiol       Date:  2011-12-15       Impact factor: 2.778

Review 2.  Electrocardiographic classification of acute myocardial ischemia.

Authors:  S Sclarovsky; A Mager; J Kusniec; E Rechavia; A Sagie; R Bassevich; B Strasberg
Journal:  Isr J Med Sci       Date:  1990-09

3.  Prediction of clinical outcomes in patients with unprotected left main trifurcation lesions treated by drug-eluting stents: importance of 2-stent technique and SYNTAX score.

Authors:  Shao-Liang Chen; Fey Ye; Jun-Jie Zhang; Zuo-Ying Hu; Nai-Liang Tian; Jun-Xia Zhang; Tak W Kwan
Journal:  J Interv Cardiol       Date:  2010-07-19       Impact factor: 2.279

4.  Grade 3 ischemia on the admission electrocardiogram predicts rapid progression of necrosis over time and less myocardial salvage by primary angioplasty.

Authors:  Therese Billgren; Charles Maynard; Timothy F Christian; Mohmmad A Rahman; Mahammad Saeed; Stephen C Hammill; Galen S Wagner; Yochai Birnbaum
Journal:  J Electrocardiol       Date:  2005-07       Impact factor: 1.438

5.  The electrophysiologic time-course of acute myocardial ischemia and the effects of early coronary artery reperfusion.

Authors:  J L Cox; T M Daniel; J P Boineau
Journal:  Circulation       Date:  1973-11       Impact factor: 29.690

6.  Usefulness of the presenting electrocardiogram in predicting successful reperfusion with streptokinase in acute myocardial infarction.

Authors:  C K Wong; J K French; P E Aylward; M J Frey; A A Adgey; H D White
Journal:  Am J Cardiol       Date:  1999-01-15       Impact factor: 2.778

7.  Assessment of the SYNTAX score in the Syntax study.

Authors:  Patrick W Serruys; Yoshinobu Onuma; Scot Garg; Giovanna Sarno; Marcel van den Brand; Arie-Pieter Kappetein; Nic Van Dyck; Michael Mack; David Holmes; Ted Feldman; Marie-Claude Morice; Antonio Colombo; Eric Bass; Katrin Leadley; Keith D Dawkins; Gerrit-Anne van Es; Marie-Angèle M Morel; Friedrich W Mohr
Journal:  EuroIntervention       Date:  2009-05       Impact factor: 6.534

8.  Serum gamma-glutamyltransferase and the burden of atherosclerosis in patients with acute coronary syndrome.

Authors:  Mustafa Duran; Onur Kadir Uysal; Yücel Yılmaz; Ozgür Günebakmaz; Hüseyin Arınç; Ramazan Topsakal; Namık Kemal Eryol; Ali Ergin; Abdurrahman Oğuzhan; Mehmet Güngör Kaya
Journal:  Turk Kardiyol Dern Ars       Date:  2013-06

9.  Body surface mapping during percutaneous transluminal coronary angioplasty. QRS changes indicating regional myocardial conduction delay.

Authors:  H Spekhorst; A SippensGroenewegen; G K David; M J Janse; A J Dunning
Journal:  Circulation       Date:  1990-03       Impact factor: 29.690

10.  Prognostic significance of the admission electrocardiogram in acute myocardial infarction.

Authors:  Y Birnbaum; I Herz; S Sclarovsky; B Zlotikamien; A Chetrit; L Olmer; G I Barbash
Journal:  J Am Coll Cardiol       Date:  1996-04       Impact factor: 24.094

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  2 in total

1.  QRS complex distortion (Grade 3 ischaemia) as a predictor of myocardial damage assessed by cardiac magnetic resonance imaging and clinical prognosis in patients with ST-elevation myocardial infarction.

Authors:  Karl-Philipp Rommel; Hadeel Badarnih; Steffen Desch; Matthias Gutberlet; Gerhard Schuler; Holger Thiele; Ingo Eitel
Journal:  Eur Heart J Cardiovasc Imaging       Date:  2015-06-09       Impact factor: 6.875

2.  Early/Subtle Electrocardiography Features of Acute Coronary Syndrome and ST-Segment Elevation Myocardial Infarction.

Authors:  R Gunaseelan; M Sasikumar; B Nithya; K Aswin; G Ezhilkugan; S S Anuusha; N Balamurugan; M Vivekanandan
Journal:  J Emerg Trauma Shock       Date:  2022-04-04
  2 in total

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