Prognostic significance of the distortion of terminal portion of QRS complex on admission electrocardiogram in ST segment elevation myocardial infarction

• Published in: Indian heart journal 2013-12, Vol.65 (6), p.671-677
• Main Authors: Mulay, Dnyaneshwar V, Mukhedkar, Sachin M
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Aged, 80 and over; AMI; Cardiovascular; Cause of Death; Cohort Studies; ECG changes; Electrocardiography - methods; Female; Hospital Mortality; Humans; India; Logistic Models; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - diagnosis; Myocardial Infarction - mortality; Myocardial Infarction - therapy; Original; Patient Admission - statistics & numerical data; Prognosis; Prospective Studies; Sensitivity and Specificity; Severity of Illness Index; Sex Factors; Survival Analysis
• ISSN: 0019-4832
• DOI: 10.1016/j.ihj.2013.10.012

Abstract Background ECG on admission has been used in predicting prognosis and risk stratification in ST segment elevation acute myocardial infarction (STEMI). Objective To analyze the admission ECG in STEMI based on abnormality observed in terminal portion of QRS and its correlation to hospital mortality. Method 160 consecutive patients of STEMI were classified into subjects without (Group I) and with distortion of terminal QRS (Group II), Pattern A – Emergence of J point at ≥50% of the R wave amplitude in leads with qR configuration or Pattern B – Absence of the S waves, in leads with Rs configuration in two consecutive leads. Results Out of 160 patients of STEMI, 69 (43.1%) had distortion of QRS. There were 13 deaths (8.1%). Hospital mortality was found to be significantly more in subjects with distortion than those without (15.9% V/S 2.1%, p