Key result
A positive change in the Selvester QRS score after percutaneous coronary intervention independently predicted a higher risk of 2-year mortality (HR 5.122) in patients with acute STEMI.
Why the study?
The study aimed to demonstrate the prognostic value of Selvester QRS scores in patients with acute ST-segment elevation myocardial infarction.
Do baseline Selvester QRS scores and changes in QRS scores predict 2-year mortality and MACE in patients with acute STEMI undergoing PCI?
Observational (n=289)
No
Do baseline Selvester QRS scores and changes in QRS scores predict 2-year mortality and MACE in patients with acute STEMI undergoing PCI?
Baseline Selvester QRS scores and their changes after PCI are strong independent predictors of 2-year mortality and MACE in patients with acute STEMI.
QRS scores associated with higher 2-year mortality in CAD; hypothesis-generating for risk stratification, pending prospective validation.
BACKGROUND: We aimed to demonstrate the prognostic value of Selvester QRS scores in patients with acute ST-segment elevation myocardial infarction (STEMI). METHODS: In this prospective, observational study, we screened 289 patients with acute STEMI who underwent percutaneous coronary intervention (PCI) from 1 January 2014 to 1 June 2015 at the Second Hospital of Dalian Medical University. Selvester QRS scores were calculated at the time of hospital admission and within 24 h after treatment for PCI. The primary endpoint was the 2-year mortality rate, and the secondary endpoint was any nonfatal major adverse cardiovascular event (MACE). RESULTS: Of the 289 patients, the QRS score increased in 115 (39.8%), and the 2-year mortality and MACE rates were significantly higher in these patients than in those in whom the QRS score decreased or remained unchanged after the treatment of PCI. Multivariable Cox regression analysis revealed that both baseline QRS scores and changes in QRS scores were independently associated with the 2-year mortality rate [hazard ratio (HR) 1.462, 95% confidence interval (95% CI) 1.279-1.671 and HR 5.122, 95% CI 2.128-12.328, respectively), MACE rate (HR 1.119, 95% CI 1.019-1.229 and HR 2.585, 95% CI 1.260-5.303, respectively) and composite endpoint (HR 1.137, 95% CI 1.047-1.236 and HR 3.152, 95% CI 1.704-5.829, respectively) after adjusting for other risk factors. CONCLUSION: In conclusion, both baseline Selvester QRS scores and changes in QRS scores independently predicted poor outcomes in patients with acute STEMI who underwent PCI.
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Liu et al. (2020) conducted an observational in Acute ST-segment elevation myocardial infarction (STEMI) (n=289). Positive change in Selvester QRS score (ΔQRS > 0) vs. Negative or no change in QRS score (ΔQRS ≤ 0) was evaluated on 2-year all-cause mortality (HR 5.122, 95% CI 2.128-12.328, p=0.020). A positive change in the Selvester QRS score after percutaneous coronary intervention independently predicted a higher risk of 2-year mortality (HR 5.122) in patients with acute STEMI.
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