prognostic significance of the distortion of terminal portion of qrs complex on admission electrocardiogram in st segment elevation myocardial infarction
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2013
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Abstract
Background: ECG on admission has been used in predicting prognosis and risk stratification in ST segment elevation acute myocardial infarction (STEMI).
Objective: To analyze the admission ECG in STEMI based on abnormality observed in terminal portion of QRS and its correlation to hospital mortality.
Method: 160 consecutive patients of STEMI were classified into subjects without (Group I) and with distortion of terminal QRS (Group II), Pattern A – Emergence of J point at ≥50% of the R wave amplitude in leads with qR configuration or Pattern B – Absence of the S waves, in leads with Rs configuration in two consecutive leads.
Results: Out of 160 patients of STEMI, 69 (43.1%) had distortion of QRS. There were 13 deaths (8.1%). Hospital mortality was found to be significantly more in subjects with distortion than those without (15.9% V/S 2.1%, p < 0.001). Patients with QRS distortion tended to have larger infarction as assessed by Killip class on admission (p < 0.05), anterior location of MI (p < 0.01) and presence of significant Q waves in leads with ST segment elevation (p < 0.0001).
With multiple logistic regression analysis using hospital mortality as a dependent variable and all studied risk factors as independent variables, QRS distortion on admission ECG was the only variable found to be statistically significant (Adjusted OR = 7.161, p < 0.05).
Conclusion: ECG on admission is a simple, cheap, universally available investigation that can predict the short term prognosis in STEMI and would help in deciding which patients should go for other myocardial revascularization procedures.
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| Reference Key |
mulay2013indianprognostic
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|---|---|
| Authors | ;Dnyaneshwar V. Mulay;Sachin M. Mukhedkar |
| Journal | renewable energy |
| Year | 2013 |
| DOI |
10.1016/j.ihj.2013.10.012
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| URL | |
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