A QRS duration ≥120 msec upon admission predicted in-hospital mortality with 78.5% sensitivity and 100% specificity in patients with acute myocardial infarction caused by LMCA occlusion.
Observational (n=20)
No
Does a QRS interval ≥ 120 msec upon admission predict in-hospital mortality in patients with acute myocardial infarction caused by left main coronary artery occlusion?
A QRS duration ≥ 120 msec upon admission is a strong predictor of in-hospital mortality in patients with acute myocardial infarction caused by left main coronary artery occlusion.
p-value: p=0.001
BACKGROUND: Acute myocardial infarction (AMI) caused by left main coronary artery (LMCA) occlusion is associated with a severe clinical course and catastrophic consequences. HYPOTHESIS: We sought to clarify ECG predictors of prognosis in AMI caused by LMCA occlusion. METHODS: We examined 20 consecutive patients with AMI caused by LMCA occlusion that was treated by primary stenting. The patients were assigned to either a group that survived (S) and was discharged from hospital, or a group that did not survive (NS) and died in hospital. We compared ECG findings upon admission, angiographic findings, laboratory data and clinical outcomes. RESULTS: The rate of having Thrombolysis In Myocardial Infarction (TIMI) grade > 2 coronary flow before PCI and of achieving TIMI grade 3 after PCI was significantly lower in the NS than the S group (14.3% vs. 83.3%, p = 0.003 and 35.7% vs. 100%, p = 0.008). The ECG findings showed longer QRS interval in the NS than in the S group (150.5 ± 37.9 vs. 105.2 ± 15.4, p = 0.022). A QRS interval ≥ 120 msec predicted in-hospital mortality with sensitivity, specificity and positive and negative predictive values of 78.5%, 100%, 100% and 66.7%, respectively, in this population. CONCLUSIONS: The QRS duration upon admission was a good predictor of in-hospital mortality among patients with AMI caused by LMCA occlusion. This ECG sign could be useful in the emergency clinical setting.
Sasaki et al. (Mon,) ont mené une étude observationnelle sur l'infarctus du myocarde aigu causé par l'occlusion de l'artère coronaire principale gauche (n=20). L'intervalle QRS ≥ 120 msec à l'admission par rapport à l'intervalle QRS < 120 msec a été évalué sur la mortalité hospitalière (p=0.001). Une durée de QRS ≥ 120 msec à l'admission prédisait la mortalité hospitalière avec une sensibilité de 78.5 % et une spécificité de 100 % chez les patients ayant subi un infarctus du myocarde aigu causé par l'occlusion de l'ACMG.