Complete versus simplified Selvester QRS score for infarct severity assessment in ST-elevation myocardial infarction

Autor: Bernhard Metzler, Ivan Lechner, Michael Schreinlechner, Sebastian J. Reinstadler, Christina Tiller, Nicolas Hein, Gert Klug, Agnes Mayr, Alexander Peherstorfer, Martin Reindl, Magdalena Holzknecht
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
lcsh:Diseases of the circulatory (Cardiovascular) system
medicine.medical_specialty
Time Factors
Action Potentials
Magnetic Resonance Imaging
Cine
030204 cardiovascular system & hematology
Severity of Illness Index
03 medical and health sciences
QRS complex
Electrocardiography
0302 clinical medicine
Percutaneous Coronary Intervention
Troponin T
Cardiac magnetic resonance imaging
Interquartile range
Heart Conduction System
Heart Rate
Predictive Value of Tests
Internal medicine
medicine
Humans
030212 general & internal medicine
Myocardial infarction
cardiovascular diseases
Prospective Studies
Risk stratification
Angiology
Aged
medicine.diagnostic_test
business.industry
Myocardium
Area under the curve
Middle Aged
medicine.disease
Cardiac surgery
ST-segment elevation myocardial infarction
Treatment Outcome
lcsh:RC666-701
Cardiology
cardiovascular system
ST Elevation Myocardial Infarction
Female
Cardiology and Cardiovascular Medicine
business
Biomarkers
Research Article
Zdroj: BMC Cardiovascular Disorders
BMC Cardiovascular Disorders, Vol 19, Iss 1, Pp 1-7 (2019)
ISSN: 1471-2261
Popis: Background Complete and simplified Selvester QRS score have been proposed as valuable clinical tool for estimating myocardial damage in patients with ST-elevation myocardial infarction (STEMI). We sought to comprehensively compare both scoring systems for the prediction of myocardial and microvascular injury assessed by cardiac magnetic resonance (CMR) imaging in patients with acute STEMI. Methods In this prospective observational study, 201 revascularized STEMI patients were included. Electrocardiography was conducted at a median of 2 (interquartile range 1–4) days after the index event to evaluate the complete and simplified QRS scores. CMR was performed within 1 week and 4 months thereafter to determine acute and chronic infarct size (IS) as well as microvascular obstruction (MVO). Results Complete and simplified QRS score showed comparable predictive value for acute (area under the curve (AUC) = 0.64 vs. 0.67) and chronic IS (AUC = 0.63 vs. 0.68) as well as for MVO (AUC = 0.64 vs. 0.66). Peak high sensitivity cardiac troponin T (hs-cTnT) showed an AUC of 0.88 for acute IS and 0.91 for chronic IS, respectively. For the prediction of MVO, peak hs-cTnT represented an AUC of 0.81. Conclusions In reperfused STEMI, complete and simplified QRS score displayed comparable value for the prediction of acute and chronic myocardial as well as microvascular damage. However, both QRS scoring systems provided inferior predictive validity, compared to peak hs-cTnT, the clinical reference method for IS estimation.
Databáze: OpenAIRE
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