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Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction

Objective: To evaluate the diagnostic performance of selected baseline electrocardiographic (ECG) parameters as predictors of left ventricular remodeling (LVR) in patients with a first ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). M...

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Autores principales: Kasprzak, Michał, Fabiszak, Tomasz, Koziński, Marek, Kubica, Jacek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198269/
https://www.ncbi.nlm.nih.gov/pubmed/34072364
http://dx.doi.org/10.3390/jcm10112405
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author Kasprzak, Michał
Fabiszak, Tomasz
Koziński, Marek
Kubica, Jacek
author_facet Kasprzak, Michał
Fabiszak, Tomasz
Koziński, Marek
Kubica, Jacek
author_sort Kasprzak, Michał
collection PubMed
description Objective: To evaluate the diagnostic performance of selected baseline electrocardiographic (ECG) parameters as predictors of left ventricular remodeling (LVR) in patients with a first ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods: The study was performed as a single-center cohort study, with 249 patients (74.7% males) included in the final analysis. Nine baseline ECG parameters were evaluated, with respect to occurrence of LVR 6 months after STEMI (defined as an echocardiography-assessed relative >20% increase in end-diastolic left ventricular volume compared with the value at discharge from hospital). Results: The baseline ECG predictors of LVR, identified in univariate analysis, included the number of leads with ST-segment elevation (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.03–1.38, p = 0.0212), number of leads with Q-waves (OR 1.21, 95% CI 1.07–1.37, p = 0.0033), sum of ST-segment elevation (OR 1.04, 95% CI 1.00–1.08; p = 0.0253) and maximal ST-segment elevation (OR 1.14; 95% CI 1.00–1.29; p = 0.0446). When added to demographic, clinical and angiographic data, the number of leads with ST-segment elevation (OR 1.17, 95% CI 1.01–1.36; p = 0.0413), number of leads with Q-waves (OR 1.15, 95% CI 1.01–1.32; p = 0.0354) and the sum of ST-segment elevation (OR 1.04, 95% CI 1.00–1.08; p = 0.0331) successfully predicted development of LVR in multivariate logistic regression models. However, after inclusion of biochemical data in multivariate models, none of the electrocardiographic parameters, but increasing body weight, TIMI flow after PCI < 3 and higher maximal values of myocardial necrosis biomarker, was independently associated with the occurrence of LVR 6 months after STEMI. Conclusions: Our study demonstrates modest utility of pre-reperfusion ECG for the prediction of LVR occurrence after six months of STEMI.
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spelling pubmed-81982692021-06-14 Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction Kasprzak, Michał Fabiszak, Tomasz Koziński, Marek Kubica, Jacek J Clin Med Article Objective: To evaluate the diagnostic performance of selected baseline electrocardiographic (ECG) parameters as predictors of left ventricular remodeling (LVR) in patients with a first ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods: The study was performed as a single-center cohort study, with 249 patients (74.7% males) included in the final analysis. Nine baseline ECG parameters were evaluated, with respect to occurrence of LVR 6 months after STEMI (defined as an echocardiography-assessed relative >20% increase in end-diastolic left ventricular volume compared with the value at discharge from hospital). Results: The baseline ECG predictors of LVR, identified in univariate analysis, included the number of leads with ST-segment elevation (odds ratio (OR) 1.19, 95% confidence interval (CI) 1.03–1.38, p = 0.0212), number of leads with Q-waves (OR 1.21, 95% CI 1.07–1.37, p = 0.0033), sum of ST-segment elevation (OR 1.04, 95% CI 1.00–1.08; p = 0.0253) and maximal ST-segment elevation (OR 1.14; 95% CI 1.00–1.29; p = 0.0446). When added to demographic, clinical and angiographic data, the number of leads with ST-segment elevation (OR 1.17, 95% CI 1.01–1.36; p = 0.0413), number of leads with Q-waves (OR 1.15, 95% CI 1.01–1.32; p = 0.0354) and the sum of ST-segment elevation (OR 1.04, 95% CI 1.00–1.08; p = 0.0331) successfully predicted development of LVR in multivariate logistic regression models. However, after inclusion of biochemical data in multivariate models, none of the electrocardiographic parameters, but increasing body weight, TIMI flow after PCI < 3 and higher maximal values of myocardial necrosis biomarker, was independently associated with the occurrence of LVR 6 months after STEMI. Conclusions: Our study demonstrates modest utility of pre-reperfusion ECG for the prediction of LVR occurrence after six months of STEMI. MDPI 2021-05-29 /pmc/articles/PMC8198269/ /pubmed/34072364 http://dx.doi.org/10.3390/jcm10112405 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kasprzak, Michał
Fabiszak, Tomasz
Koziński, Marek
Kubica, Jacek
Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title_full Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title_fullStr Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title_full_unstemmed Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title_short Diagnostic Performance of Selected Baseline Electrocardiographic Parameters for Prediction of Left Ventricular Remodeling in Patients with ST-Segment Elevation Myocardial Infarction
title_sort diagnostic performance of selected baseline electrocardiographic parameters for prediction of left ventricular remodeling in patients with st-segment elevation myocardial infarction
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8198269/
https://www.ncbi.nlm.nih.gov/pubmed/34072364
http://dx.doi.org/10.3390/jcm10112405
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