Key result
An abnormal QRS-T angle of ≥90 degrees on admission ECG in patients with acute STEMI was associated with significantly larger infarct size (36.5% vs 13.3% of LV mass) compared to an angle <90 degrees.
Why the study?
The surface EKG QRS-T angle is a promising prognostic marker in CAD, but its association with myocardial damage assessed by CMR LGE in acute STEMI needed investigation.
Does an abnormal QRS-T angle on admission EKG associate with greater myocardial damage in patients with STEMI?
Observational (n=169)
No
Does an abnormal QRS-T angle on admission EKG associate with greater myocardial damage in patients with STEMI?
Absolute Event Rate: 36.5% vs 13.3%
p-value: p=<0.001
An abnormal QRS-T angle of 90 degrees or more on admission EKG in STEMI patients is significantly associated with larger infarct size and lower ejection fraction as assessed by CMR.
Supports QRS-T angle for early STEMI risk stratification; extends its prognostic link to acute infarct size.
The QRS-T angle from the surface EKG is a promising prognostic marker in patients with coronary artery disease. Cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) offers high resolution imaging of myocardial damage. We investigated the association of the QRS-T angle and the extent of myocardial damage as assessed by LGE in patients with acute ST-segment myocardial infarction (STEMI) Methods: 169 patients with STEMI obtained a standardized digital 12-lead EKG on admission for the calculation of the QRS-T angle and underwent CMR imaging for analysis of infarct size by LGE within the first week. Patients were divided into groups: (1) abnormal QRS-T angle 90 degree and (2) QRS-T angle < 90 degree. Results: Patients with a QRS-T angle of 90 degree or more had larger infarcts (36.512.4 vs. 13.39.5; p<0.001) and lower ejection fraction (42.912.1% vs. 50.610.6%; p<0.001).
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Zadeh et al. (2020) conducted an observational in ST-Segment Elevation Myocardial Infarction (STEMI) (n=169). QRS-T angle ≥ 90 degrees vs. QRS-T angle < 90 degrees was evaluated on Infarct size (Late Gadolinium Enhancement in % LV mass) (p=<0.001). An abnormal QRS-T angle of ≥90 degrees on admission ECG in patients with acute STEMI was associated with significantly larger infarct size (36.5% vs 13.3% of LV mass) compared to an angle <90 degrees.
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