Key result
Baseline ECG parameters show no independent link to post-STEMI LV remodeling when including biochemical data.
Why the study?
To evaluate the diagnostic performance of selected baseline ECG parameters as predictors of left ventricular remodeling in patients with a first STEMI treated with primary PCI.
Do baseline ECG parameters predict left ventricular remodeling in patients with a first STEMI treated with primary PCI?
Cohort (n=249)
No
Do baseline ECG parameters predict left ventricular remodeling in patients with a first STEMI treated with primary PCI?
Baseline pre-reperfusion ECG parameters have modest utility and are not independent predictors of left ventricular remodeling 6 months after STEMI when biochemical data are included.
Baseline ECG parameters lack independent value for post-STEMI LVR beyond biomarkers; hypothesis-generating for early triage in biomarker-sparse settings.
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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Kasprzak et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=249). Baseline electrocardiographic (ECG) parameters was evaluated on Left ventricular remodeling (LVR) 6 months after STEMI. Baseline ECG parameters were not independently associated with left ventricular remodeling 6 months after STEMI when biochemical data were included in multivariate models.
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