In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention
| Autor: | Petr Lokaj, Lumír Koc, Tomas Ondrus, Petr Kala, Katerina Hnatkova, Tomas Novotny, Pavla Cuckova, Jiri Parenica, Maria Holicka, Marek Malik |
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| Rok vydání: | 2021 |
| Předmět: |
Medicine (General)
medicine.medical_specialty medicine.medical_treatment Clinical Biochemistry 030204 cardiovascular system & hematology Chest pain QT interval Article 03 medical and health sciences R5-920 0302 clinical medicine St elevation myocardial infarction Internal medicine Medicine In patient cardiovascular diseases 030212 general & internal medicine Pathological Q wave Pathological business.industry Percutaneous coronary intervention primary percutaneous coronary intervention 3. Good health ST elevation myocardial infarction Selvester score Cardiology Long term mortality Q wave medicine.symptom business |
| Zdroj: | Diagnostics, Vol 11, Iss 799, p 799 (2021) Diagnostics Volume 11 Issue 5 |
| ISSN: | 2075-4418 |
| Popis: | The development of pathological Q waves has long been correlated with worsened outcome in patients with ST elevation myocardial infarction (STEMI). In this study, we investigated long-term mortality of STEMI patients treated by primary percutaneous coronary intervention (PPCI) and compared predictive values of Q waves and of Selvester score for infarct volume estimation. Data of 283 consecutive STEMI patients (103 females) treated by PPCI were analysed. The presence of pathological Q wave was evaluated in pre-discharge electrocardiograms (ECGs) recorded ≥72 h after the chest pain onset (72 h Q). The Selvester score was evaluated in acute ECGs (acute Selvester score) and in the pre-discharge ECGs (72 h Selvester score). The results were related to total mortality and to clinical and laboratory variables. A 72 h Q presence and 72 h Selvester score ≥6 was observed in 184 (65.02%) and 143 (50.53%) patients, respectively. During a follow-up of 5.69 ± 0.66 years, 36 (12.7%) patients died. Multivariably, 72 h Selvester score ≥6 was a strong independent predictor of death, while a predictive value of the 72 h Q wave was absent. In high-risk subpopulations defined by clinical and laboratory variables, the differences in total mortality were highly significant (p < 0.01 for all subgroups) when stratified by 72 h Selvester score ≥6. On the contrary, the additional risk-prediction by 72 h Q presence was either absent or only borderline. In contemporarily treated STEMI patients, Selvester score is a strong independent predictor of long-term all-cause mortality. On the contrary, the prognostic value of Q-wave presence appears limited in contemporarily treated STEMI patients. |
| Databáze: | OpenAIRE |
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