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...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2019-11-01
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| Series: | Indian Heart Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0019483219304146 |
| _version_ | 1818732877044514816 |
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| author | Abhishek C. Sawant Aishwarya Bhardwaj Shantanu Srivatsa Srilekha Sridhara Meghana Prakash Hiriyur Prakash Nidhi Kanwar Janelle Rodriguez Gary Tse Tong Liu Arnav Kumar Hiroko Beck Sanjay S. Srivatsa |
| author_facet | Abhishek C. Sawant Aishwarya Bhardwaj Shantanu Srivatsa Srilekha Sridhara Meghana Prakash Hiriyur Prakash Nidhi Kanwar Janelle Rodriguez Gary Tse Tong Liu Arnav Kumar Hiroko Beck Sanjay S. Srivatsa |
| author_sort | Abhishek C. Sawant |
| collection | DOAJ |
| 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. Keywords: ST-elevation myocardial infarction, Risk score, Predictors of mortality, Frontal QRS-T angle, Percutaneous coronary revascularization, Central valley risk score |
| first_indexed | 2024-12-17T23:40:33Z |
| format | Article |
| id | doaj.art-91297d0d17bb43d7bb59d97628baad6e |
| institution | Directory Open Access Journal |
| issn | 0019-4832 |
| language | English |
| last_indexed | 2024-12-17T23:40:33Z |
| publishDate | 2019-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Indian Heart Journal |
| spelling | doaj.art-91297d0d17bb43d7bb59d97628baad6e2022-12-21T21:28:27ZengElsevierIndian Heart Journal0019-48322019-11-01716481487Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarctionAbhishek C. Sawant0Aishwarya Bhardwaj1Shantanu Srivatsa2Srilekha Sridhara3Meghana Prakash Hiriyur Prakash4Nidhi Kanwar5Janelle Rodriguez6Gary Tse7Tong Liu8Arnav Kumar9Hiroko Beck10Sanjay S. Srivatsa11Division of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ, USADivision of Cardiology, State University of New York at Buffalo, Buffalo, NY, USADepartment of Medicine, Community Regional Medical Center, Fresno, CA, USADivision of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ, USADivision of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ, USADivision of Cardiology, State University of New York at Buffalo, Buffalo, NY, USADivision of Interventional Cardiology, Banner University Medical Center, Phoenix, AZ, USADepartment of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong, SAR, PR ChinaTianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, PR ChinaAndreas Gruentzig Cardiovascular Center, Emory University School of Medicine, Atlanta, GA, USADivision of Cardiology, State University of New York at Buffalo, Buffalo, NY, USADepartment of Medicine, Community Regional Medical Center, Fresno, CA, USA; Corresponding author. 7206 N Milburn Ave #105, Fresno, CA, 93722, USA.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. Keywords: ST-elevation myocardial infarction, Risk score, Predictors of mortality, Frontal QRS-T angle, Percutaneous coronary revascularization, Central valley risk scorehttp://www.sciencedirect.com/science/article/pii/S0019483219304146 |
| spellingShingle | Abhishek C. Sawant Aishwarya Bhardwaj Shantanu Srivatsa Srilekha Sridhara Meghana Prakash Hiriyur Prakash Nidhi Kanwar Janelle Rodriguez Gary Tse Tong Liu Arnav Kumar Hiroko Beck Sanjay S. Srivatsa Prognostic value of frontal QRS-T angle in predicting survival after primary percutaneous coronary revascularization/coronary artery bypass grafting for ST-elevation myocardial infarction Indian Heart Journal |
| 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 |
| url | http://www.sciencedirect.com/science/article/pii/S0019483219304146 |
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