Key result
Distortion of the terminal portion of the QRS complex on admission ECG predicted a lower incidence of TIMI flow grade 3 (52% vs 84%, P<0.05) and higher in-hospital mortality (19% vs 0%, P<0.05).
Why the study?
Does distortion of the terminal portion of the QRS complex on admission ECG predict worse outcomes after emergency angioplasty in patients with anterior wall acute myocardial infarction?
Cohort (n=42)
Does distortion of the terminal portion of the QRS complex on admission ECG predict worse outcomes after emergency angioplasty in patients with anterior wall acute myocardial infarction?
Absolute Event Rate: 52% vs 84%
p-value: p=< 0.05
Distortion of the terminal QRS complex on admission ECG is a useful predictor of impaired reflow and higher in-hospital mortality in patients with anterior MI undergoing emergency angioplasty.
Terminal QRS distortion was associated with impaired reflow and higher mortality after anterior MI angioplasty; hypothesis-generating for ECG-based risk stratification.
BACKGROUND: In patients with acute myocardial infarction, distortion of the terminal portion of the QRS complex on the electrocardiogram (ECG) at the time of their admission to hospital is associated with larger final infarct size and greater mortality. This study assessed the results of emergency coronary angioplasty in patients with anterior acute myocardial infarction with and without distortion of the terminal portion of the QRS complex on the admission ECG. METHODS: We assessed the Thrombolysis in Myocardial Infarction (TIMI) trial flow grade, resolution of ischemic ECG changes, and clinical outcome after emergency angioplasty for acute anterior wall myocardial infarction in patients with (n = 21) and without (n = 21) distortion of the terminal portion of the QRS complex on the admission ECG. RESULTS: Compared with patients without distortion of the terminal portion of the QRS complex on the admission ECG, those with distortion had a significantly lower incidence of TIMI flow grade 3 (52% compared with 84%, P < 0.05), lower rate of resolution of the ischemic ECG changes (33% compared with 84%, P < 0.005), and greater rate of mortality during their stay in hospital despite successful balloon angioplasty (19% compared with 0%, P < 0.05). CONCLUSIONS: In patients with anterior wall acute myocardial infarction, distortion of the terminal portion of the QRS complex on the admission ECG predicts a greater mortality rate and a greater incidence of reflow impairment after emergency angioplasty.
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Mager et al. (1998) conducted a cohort in Anterior wall acute myocardial infarction (n=42). Distortion of the terminal portion of the QRS complex on admission ECG vs. No distortion of the terminal portion of the QRS complex on admission ECG was evaluated on TIMI flow grade 3 (p=< 0.05). Distortion of the terminal portion of the QRS complex on admission ECG predicted a lower incidence of TIMI flow grade 3 (52% vs 84%, P<0.05) and higher in-hospital mortality (19% vs 0%, P<0.05).
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