Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

Fakhri, Yama; Schoos, Mikkel Malby; Sejersten, Maria; Ersbøll, Mads; Valeur, Nana; Køber, Lars; Hassager, Christian; Wagner, Galen S.; Kastrup, Jens; Clemmensen, Peter

doi:10.1016/j.jelectrocard.2016.11.002

Cited by 6 publications

(3 citation statements)

References 38 publications

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“…Fakhri et al demonstrated the association of MAW score with increasing NT-proBNP levels. In STEMI patients with severe ischemia, neurohormonal activation is inversely associated with ECG patterns of acute myocardial ischemia [38].…”

Section: Mawmentioning

confidence: 99%

Added Value of Modified Anderson–Wilkins Acuteness Score in Prognostication of Patients with Acute Myocardial Infarction

Serafimov

Taravari

Shehu

et al. 2020

Open Access Maced J Med Sci

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BACKGROUND: Electrocardiogram (ECG) signs on admission can serve as a prognostic marker in patients treated for myocardial infarction (MI). AIM: The aim of the study was to determine the predictive role of modified Anderson–Wilkins (MAW) ECG score of acuteness on the extent of myocardial injury, left ventricular (LV) remodeling, and clinical outcome in patients with acute MI. METHODS: Prospective, observational cohort study on patients treated for MI at the University Clinic for Cardiology. Subjects were analyzed for their demographic, clinical, ECG, LV functional, angiographic variables, course of treatment, and in-hospital outcome. MAW score was calculated for each patient. Patients were comparatively analyzed divided in two groups (score <3 and ≥3). RESULTS: One hundred fifty patients (70% males and 30% females), aged 60.9 years were included in the study. Sixty-eight patients had MAW score <3 (mean 1.7), and 82 had score ≥3 (mean 3.5), p>0.001. Patients with ST-segment elevation MI had OR 2.1 (p>0.000), and patients with multiple locations (excluding anterior) had OR 2.1 (p > 0.000) of having MAW score ≥3. They received mechanical reperfusion 1.9 (p = 0.032) times more often. High MAW score was associated with stress hyperglycemia (OR 2.1; p = 0.032); low potassium (OR 2.8; p = 0.032), lower creatinine (p = 0.050), and higher NT-proBNP (OR 2.5; p = 0.050). High MAW score was associated with decreased LV function and increased LV dimensions on the follow-up echocardiography (p = 0.050 and 0.012, respectively). CONCLUSION: ECG is an important prognostic tool in MI patients. ECG-derived MAW score demonstrates a strong correlation with stress hyperglycemia, potassium, creatinine, and natriuretic peptides level and can serve as an early marker of LV remodeling after MI.

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Section: Mawmentioning

confidence: 99%

Added Value of Modified Anderson–Wilkins Acuteness Score in Prognostication of Patients with Acute Myocardial Infarction

Serafimov

Taravari

Shehu

et al. 2020

Open Access Maced J Med Sci

View full text Add to dashboard Cite

show abstract

“…More research is warranted to confirm this hypothesis. Severity score and acuteness-scores of myocardial ischemia from the prehospital ECG may be of value as a stratification and inclusion parameter in designing future clinical trials of reperfusion strategies in patients with STEMI (27).…”

Section: Time Delays For Reperfusion Therapymentioning

confidence: 99%

Electrocardiographic scores of severity and acuteness of myocardial ischemia predict myocardial salvage in patients with anterior ST-segment elevation myocardial infarction

Arheden

Atar

Dubois‐Randé

et al. 2017

Journal of Electrocardiology

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“…Chest pain is the most common presenting complaint of AIHD [4,5]. Various studies have shown that prompt identification of AIHD is important [6], and delayed treatment of AIHD leads to poor outcomes [7,8]. However, making a precise and early diagnosis for chest pain is difficult [9][10][11].…”

Section: Introductionmentioning

confidence: 99%

Emergency department routine data and the diagnosis of acute ischemic heart disease in patients with atypical chest pain

Kim

Park

et al. 2020

PLoS ONE

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Background Due to an aging population and the increasing proportion of patients with various comorbidities, the number of patients with acute ischemic heart disease (AIHD) who present to the emergency department (ED) with atypical chest pain is increasing. The aim of this study was to develop and validate a prediction model for AIHD in patients with atypical chest pain. Methods and results A chest pain workup registry, ED administrative database, and clinical data warehouse database were analyzed and integrated by using nonidentifiable key factors to create a comprehensive clinical dataset in a single academic ED from 2014 to 2018. Demographic findings, vital signs, and routine laboratory test results were assessed for their ability to predict AIHD. An extreme gradient boosting (XGB) model was developed and evaluated, and its performance was compared to that of a single-variable model and logistic regression model. The area under the receiver operating characteristic curve (AUROC) was calculated to assess discrimination. A calibration plot and partial dependence plots were also used in the analyses. Overall, 4,978 patients were analyzed. Of the 3,833 patients in the training cohort, 453 (11.8%) had AIHD; of the 1,145 patients in the validation cohort, 166 (14.5%) had AIHD. XGB, troponin (single-variable), and logistic regression models showed similar discrimination power (AUROC [95% confidence interval]: XGB model, 0.75 [0.71–0.79]; troponin model, 0.73 [0.69–0.77]; logistic regression model, 0.73 [0.70–0.79]). Most patients were classified as non-AIHD; calibration was good in patients with a low predicted probability of AIHD in all prediction models. Unlike in the logistic regression model, a nonlinear relationship-like threshold and U-shaped relationship between variables and the probability of AIHD were revealed in the XGB model. Conclusion We developed and validated an AIHD prediction model for patients with atypical chest pain by using an XGB model.

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Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

Cited by 6 publications

References 38 publications

Added Value of Modified Anderson–Wilkins Acuteness Score in Prognostication of Patients with Acute Myocardial Infarction

Added Value of Modified Anderson–Wilkins Acuteness Score in Prognostication of Patients with Acute Myocardial Infarction

Electrocardiographic scores of severity and acuteness of myocardial ischemia predict myocardial salvage in patients with anterior ST-segment elevation myocardial infarction

Emergency department routine data and the diagnosis of acute ischemic heart disease in patients with atypical chest pain

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