Prognostic value of predischarge 12 lead electrocardiogram after myocardial infarction compared with other routine clinical variables.

Abstract

The prognostic value of QRS score (Selvester), ST depression, ST elevation, extrasystoles, P terminal force in V1, and QTc derived from the predischarge 12 lead electrocardiogram was assessed after myocardial infarction in 474 patients without intraventricular conduction defects, ventricular hypertrophy, or atrial fibrillation. The usefulness of these results in risk assessment was compared with that of other clinical data. During follow up 45 patients died. Logistic regression analysis showed that QRS score, ST depression, and QTc were independently predictive of cardiac mortality. When multivariate analysis was applied to clinical and electrocardiographic data together, however, the 12 lead electrocardiogram did not provide independent information additional to that provided by other routine clinical findings and laboratory tests such as a history of previous myocardial infarction, clinical signs of persistent heart failure, indication for digitalis or antiarrhythmic drugs at discharge, and enlarged heart on chest x ray. In conclusion, the electrocardiogram has important prognostic value; however, it is not powerful enough to further improve the risk assessment of post-infarction patients.

Relationship between QRS score and microvascular obstruction after acute anterior myocardial infarction

“…Previous studies have shown the prognostic value of the 12-lead ECG among patients with ST-elevation MI [7,8,18]. Additionally, Selvester's QRS score has been used to assess the extent of myocardial damage and prognosis [6,7].…”

Predictive role of Selvester QRS score in patients undergoing transcatheter aortic valve replacement

“…The percentage of patients with LV systolic dysfunction was also higher in the group with a score of 3 or higher. Other studies have also shown a correlation between the percentage of fibrosis and systolic dysfunction 17,18 …”

“…The amount of myocardial fibrosis is not a component of traditional surgical risk scores, and in the literature some studies have reported a correlation between the amount of fibrosis and mortality, both in other heart diseases 17,18,30 and also in AS 31 . Other publications have shown that the Selvester QRS score was well correlated with the estimation of fibrosis and cardiac imaging studies 32‐36 .…”

“…In the 1970s, Selvester et al 12 correlated the findings of myocardial biopsies with the standard 12‐lead electrocardiogram (ECG) and showed that changes in electrical activity can locate and estimate the sizes of fibrotic areas in patients with ischemic cardiomyopathy. Later studies have compared the correlation of the Selvester QRS score with the late enhancement in cardiac resonance 13,14 and other studies showed that this QRS score had an important prognostic value 15‐18 …”

A Simplified Clinical Electrocardiogram Score for the Prediction of Cardiovascular Mortality

“…4,9 Many studies have shown that the SSS is directly related to both the size of the infarction and CV mortality. 10,11 Ratajarju et al developed the Cardiac Infarction Injury Score to improve the diagnosis of myocardial infarction. 3 Its ability to predict CV and all-cause mortality has been demonstrated.…”