In 299 revascularized STEMI patients, a higher Selvester QRS score (>5) independently predicted hemorrhagic myocardial infarction (OR 1.17, p=0.002) and increased MACE risk (19% vs 9%).
Does the Selvester QRS score predict hemorrhagic STEMI and major adverse cardiac events in revascularized STEMI patients?
The Selvester QRS score serves as a simple, independent electrocardiographic predictor of intramyocardial hemorrhage and long-term major adverse cardiac events in revascularized STEMI patients.
Absolute Event Rate: 0% vs 0%
Abstract Background Intramyocardial hemorrhage (IMH) in the setting of ST-elevation myocardial infarction (STEMI) has important prognostic implications. However, little is known about clinical predictors of hemorrhagic STEMI. The electrocardiographic Selvester QRS score was originally developed to assess the extent of myocardial injury in patients with STEMI, but its role in predicting hemorrhagic STEMI is unclear. Purpose The aim of the present study was therefore to investigate the value of the Selvester QRS score for the prediction of IMH in acute STEMI patients. Methods In this prospective cohort study, we included 299 revascularized STEMI patients. Electrocardiography was performed at a median of 2 (Q1-Q3: 1-4) days after infarction to determine the Selvester QRS score. The primary endpoint was hemorrhagic STEMI, defined by the presence of IMH according to comprehensive cardiac magnetic resonance T2* mapping. Clinical endpoint was the occurrence of major adverse cardiac events (MACE). Results Median QRS score at discharge was 6 points (Q1-Q3: 3-8) and hemorrhagic STEMI was present in 101 (34%) patients. The QRS score was significantly higher in patients with presence of hemorrhagic STEMI (8 vs. 5 points, p0.001). In multivariable logistic regression analysis, the QRS score remained independently associated with hemorrhagic STEMI after adjustment for other important clinical associates of IMH including anterior infarct location, pre- and post-interventional TIMI flow, peak values of troponin T and presence of pathological Q waves (odds ratio: 1.17; 95% confidence interval: 1.06 to 1.29, p=0.002). Furthermore, patients with higher QRS scoring points (5) were more likely to experience MACE (19% vs. 9%, p=0.014) during a median follow-up of 47 months. Conclusions In revascularized STEMI patients, the Selvester QRS score was significantly and independently associated with hemorrhagic STEMI and predicted worse subsequent clinical outcome. Thus, the Selvester QRS score may serve as a simple tool for the prediction of severe ischemia-reperfusion injury in STEMI survivors.
Tiller et al. (Sat,) reported a other. In 299 revascularized STEMI patients, a higher Selvester QRS score (>5) independently predicted hemorrhagic myocardial infarction (OR 1.17, p=0.002) and increased MACE risk (19% vs 9%).