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Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction
BACKGROUND: Frontal QRS-T angle (FQRST) has previously been correlated with mortality in patients with stable coronary artery disease, but its role as survival predictor after ST-elevation myocardial infarction (STEMI) remains unknown. METHODS: We evaluated 267 consecutive patients with STEMI underg...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136356/ https://www.ncbi.nlm.nih.gov/pubmed/32248922 http://dx.doi.org/10.1016/j.ihj.2019.09.008 |
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author | Sawant, Abhishek C. Bhardwaj, Aishwarya Srivatsa, Shantanu Sridhara, Srilekha Prakash, Meghana Prakash Hiriyur Kanwar, Nidhi Rodriguez, Janelle Tse, Gary Liu, Tong Kumar, Arnav Beck, Hiroko Srivatsa, Sanjay S. |
author_facet | Sawant, Abhishek C. Bhardwaj, Aishwarya Srivatsa, Shantanu Sridhara, Srilekha Prakash, Meghana Prakash Hiriyur Kanwar, Nidhi Rodriguez, Janelle Tse, Gary Liu, Tong Kumar, Arnav Beck, Hiroko Srivatsa, Sanjay S. |
author_sort | Sawant, Abhishek C. |
collection | PubMed |
description | BACKGROUND: Frontal QRS-T angle (FQRST) has previously been correlated with mortality in patients with stable coronary artery disease, but its role as survival predictor after ST-elevation myocardial infarction (STEMI) remains unknown. METHODS: We evaluated 267 consecutive patients with STEMI undergoing reperfusion or coronary artery bypass grafting. Data assessed included demographics, clinical presentation, electrocardiograms, medical therapy, and one-year mortality. RESULTS: Of 267 patients, 187 (70%) were males and most (49.4%) patients were Caucasian. All-cause mortality was significantly higher among patients with the highest (101–180°) FQRST [28% vs. 15%, p = 0.02]. Patients with FQRST 1–50° had higher survival (85.6%) compared with FQRST = 51–100° (72.3%) and FQRST = 101–180° (67.9%), [log rank, p = 0.01]. Adjusting for significant variables identified during univariate analysis, FQRST (OR = 2.04 [95% CI: 1.31–13.50]) remained an independent predictor of one-year mortality. FQRST-based risk score (1–50° = 0 points, 51–100° = 2 points, 101–180° = 5 points) had excellent discriminatory ability for one-year mortality when combined with Mayo Clinic Risk Score (C statistic = 0.875 [95%CI: 0.813–0.937]. A high (>4 points) FQRST risk score was associated with greater mortality (32% vs. 19%, p = 0.02) and longer length of stay (6 vs. 2 days, p < 0.001). CONCLUSION: FQRST represents a novel independent predictor of one-year mortality in patients with STEMI undergoing reperfusion. A high FQRST-based risk score was associated with greater mortality and longer length of stay and, after combining with Mayo Clinic Risk Score, improved discriminatory ability for one-year mortality. |
format | Online Article Text |
id | pubmed-7136356 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-71363562020-11-01 Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction Sawant, Abhishek C. Bhardwaj, Aishwarya Srivatsa, Shantanu Sridhara, Srilekha Prakash, Meghana Prakash Hiriyur Kanwar, Nidhi Rodriguez, Janelle Tse, Gary Liu, Tong Kumar, Arnav Beck, Hiroko Srivatsa, Sanjay S. Indian Heart J Originaln Article BACKGROUND: Frontal QRS-T angle (FQRST) has previously been correlated with mortality in patients with stable coronary artery disease, but its role as survival predictor after ST-elevation myocardial infarction (STEMI) remains unknown. METHODS: We evaluated 267 consecutive patients with STEMI undergoing reperfusion or coronary artery bypass grafting. Data assessed included demographics, clinical presentation, electrocardiograms, medical therapy, and one-year mortality. RESULTS: Of 267 patients, 187 (70%) were males and most (49.4%) patients were Caucasian. All-cause mortality was significantly higher among patients with the highest (101–180°) FQRST [28% vs. 15%, p = 0.02]. Patients with FQRST 1–50° had higher survival (85.6%) compared with FQRST = 51–100° (72.3%) and FQRST = 101–180° (67.9%), [log rank, p = 0.01]. Adjusting for significant variables identified during univariate analysis, FQRST (OR = 2.04 [95% CI: 1.31–13.50]) remained an independent predictor of one-year mortality. FQRST-based risk score (1–50° = 0 points, 51–100° = 2 points, 101–180° = 5 points) had excellent discriminatory ability for one-year mortality when combined with Mayo Clinic Risk Score (C statistic = 0.875 [95%CI: 0.813–0.937]. A high (>4 points) FQRST risk score was associated with greater mortality (32% vs. 19%, p = 0.02) and longer length of stay (6 vs. 2 days, p < 0.001). CONCLUSION: FQRST represents a novel independent predictor of one-year mortality in patients with STEMI undergoing reperfusion. A high FQRST-based risk score was associated with greater mortality and longer length of stay and, after combining with Mayo Clinic Risk Score, improved discriminatory ability for one-year mortality. Elsevier 2019 2019-09-09 /pmc/articles/PMC7136356/ /pubmed/32248922 http://dx.doi.org/10.1016/j.ihj.2019.09.008 Text en © 2019 Cardiological Society of India. Published by Elsevier B.V. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Originaln Article Sawant, Abhishek C. Bhardwaj, Aishwarya Srivatsa, Shantanu Sridhara, Srilekha Prakash, Meghana Prakash Hiriyur Kanwar, Nidhi Rodriguez, Janelle Tse, Gary Liu, Tong Kumar, Arnav Beck, Hiroko Srivatsa, Sanjay S. Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title | Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title_full | Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title_fullStr | Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title_full_unstemmed | Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title_short | Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction |
title_sort | prognostic value of frontal qrs-t angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for st-elevation myocardial infarction |
topic | Originaln Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136356/ https://www.ncbi.nlm.nih.gov/pubmed/32248922 http://dx.doi.org/10.1016/j.ihj.2019.09.008 |
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