Key result
QRS narrowing in the 60th minute ECG independently predicted myocardial reperfusion after primary percutaneous coronary angioplasty for acute MI (OR 1.39; 95% CI 1.25-1.54; p<0.001).
Why the study?
Does QRS duration narrowing predict myocardial reperfusion status in STEMI patients after primary PCI?
Observational (n=148)
Does QRS duration narrowing predict myocardial reperfusion status in STEMI patients after primary PCI?
QRS duration narrowing at 60 minutes post-PCI is a strong, independent electrocardiographic predictor of tissue-level myocardial reperfusion in STEMI patients.
QRS narrowing at 60 min post-PCI independently predicts tissue reperfusion; extends ECG markers beyond ST resolution for STEMI risk stratification.
AIMS: Although ischaemia-induced QRS complex changes have been described previously, their relation with reperfusion status is not clear. We aimed to investigate the relation of QRS duration with reperfusion at tissue level compared to myocardial blush in patients with acute myocardial infarction who underwent successful primary percutaneous coronary angioplasty. METHODS AND RESULTS: One hundred and forty-eight patients were enrolled. Based on the post-angioplasty myocardial blush grade (MBG), patients were divided into reperfusion (grades 2 and 3) and impaired reperfusion (grades 0 and 1) groups. Although the two groups did not differ in terms of admission QRS duration (81±17 vs. 79±15 msec, p=0.473), the patients in the impaired reperfusion group had a significantly longer QRS duration both at immediate post-angioplasty (78±18 vs. 68±17 msec, p=0.001) and at the 60th minute ECG (77±17 vs. 60±17 msec, p<0.001). Patients in the impaired reperfusion group revealed significantly less narrowing of QRS duration in the post-angioplasty 60th minute ECG (6±5 vs. 20±5 msec, p<0.001) when compared to the patients in the reperfusion group. After adjusting all variables, QRS narrowing in the 60th minute ECG was determined as an independent electrocardiographic predictor of reperfusion (OR:1.39, 95% CI: 1.25-1.54, p<0.001). CONCLUSIONS: We demonstrated that QRS duration is a strong indicator of myocardial reperfusion status.
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İlkay et al. (2012) conducted an observational in Acute ST-segment elevation myocardial infarction (n=148). QRS narrowing in the 60th minute ECG was evaluated on Myocardial reperfusion (myocardial blush grades 2 and 3) (OR 1.39, 95% CI 1.25-1.54, p=<0.001). QRS narrowing in the 60th minute ECG independently predicted myocardial reperfusion after primary percutaneous coronary angioplasty for acute MI (OR 1.39; 95% CI 1.25-1.54; p<0.001).
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