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Abstract Aims The Selvester scoring system has been derived from ECG parameters for estimating infarct size. However, there is still a lack of evidence for Selvester score as an alternative to cardiac magnetic resonance (CMR) myocardial injury makers for risk stratification and prediction of left ventricular function (LVF) recovery among patients with ST‐segment elevation myocardial infarction (STEMI). Methods and results This multicentre observational study enrolled 328 STEMI patients (88.4% men, 57.3 ± 10.6 years of age) undergoing CMR examination 1 week post‐reperfusion therapy. Patients with baseline left ventricular ejection fraction (LVEF) 0.05). A Selvester score >10 doubled the risk of MACEs in patients with systolic dysfunction (1.91 1.02 to 3.58, P = 0.04). Additionally, Selvester score, baseline LVEF, transmural infarction, and peak CK‐MB were independent predictors of recovered LVF, with Selvester score providing incremental predictive value to peak CK‐MB in predicting recovered LVF (∆AUC = 0.07, P < 0.05). Conclusions The Selvester score improves risk stratification among STEMI patients beyond LVEF and provide independent and incremental information to clinical parameters in predicting recovered LVF.
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