Regression of Q waves and clinical outcomes following primary PCI in anterior STEMI

Framond, Yuni de; Schaaf, Mathieu; Pichot-Lamoureux, Sophie; Rangé, Gregoire; Dubreuil, Olivier; Angoulvant, Denis; Claeys, Marc J.; Dorado, David García; Bochaton, Thomas; Rioufol, Gilles; Jossan, Claire; Boussaha, Inesse; Ovize, Michel; Mewton, Nathan

doi:10.1016/j.jelectrocard.2019.09.022

Cited by 3 publications

(3 citation statements)

References 28 publications

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“…Indeed, we found the sum of the Q‐wave depth on discharge ECG showed significant value for predicting the development of LVEF ≤ 40%. Moreover, a recent substudy from the CIRCUS trial revealed that persistent Q waves after reperfusion in patients with anterior MI increased the risk of developing HF or death (de Framond et al., 2019). In our study, QRS width on admission ECG predicted the development of HF or death during follow‐up.…”

Section: Discussionmentioning

confidence: 99%

“…As it is simple, cost‐effective, and fast to use, great effort has been made to study its components for possible use in assessing the prognosis of patients with MI. The presence of pathologic Q waves on the first ECG usually predicts a poor prognosis, as this finding is related to myocardial necrosis (Thygesen et al., 2019) and cardiac mortality in patients undergoing fibrinolysis (Andrews, French, Manda, & White, 2000; Bar et al., 1987; Wong et al., 2006) or percutaneous coronary intervention (PCI) (Armstrong et al., 2009) (de Framond et al., 2019) (Koivula et al, 2019). Clinical outcomes such as heart failure (HF) and repeat revascularization have also been consistently related to the presence of Q waves on presentation, regardless of infarct location, adequacy of ST resolution, or early presentation (Kumar et al., 2009).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of initial QRS analysis in anterior STEMI: Correlation with left ventricular systolic dysfunction, serum biomarkers, and cardiac outcomes

López‐Castillo

Aceña

Pello-Lázaro

et al. 2020

Noninvasive Electrocardiol

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic value of initial QRS analysis in anterior STEMI: Correlation with left ventricular systolic dysfunction, serum biomarkers, and cardiac outcomes

López‐Castillo

Aceña

Pello-Lázaro

et al. 2020

Noninvasive Electrocardiol

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“…In addition, although post-PCI TIMI flow was sufficient in most of those who underwent primary PCI, the pathological Q wave count at discharge was significantly higher in the LVT group. The pathological Q wave after reperfusion indicates that the infarct area is larger and myocardial perfusion and LV functions are worse [17]. All these factors mentioned above can be considered among the possible reasons why the incidence of LVT was high in our study.…”

Section: Discussionmentioning

confidence: 61%

Incidence and Predictors of Left Ventricular Thrombus Formation After Acute Myocardial Infarction With ST-Segment Elevation

Kurt,

Yılmaz,

Çamcı

et al. 2023

Cureus

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Background and objectiveOur prospective study aimed to evaluate the frequency and risk factors of left ventricular thrombus (LVT) occurring after acute ST-segment elevation myocardial infarction (STEMI) in the era of primary percutaneous coronary intervention (PCI). MethodsOur study included 131 patients diagnosed with acute STEMI who were followed up and treated. The presence of the thrombus was determined by transthoracic echocardiography (TTE). Study patients were evaluated as cases of thrombus (+) and thrombus (-). The relationship of electrocardiographic measurements such as the number of leads with pathological Q waves, ST segment deviation score, QT dispersion, and echocardiographic measurements such as ejection fraction (EF), end-systolic and end-diastolic volumes, and wall motion score index (WMSI) with LVT was investigated. LVT risk factors were identified. ResultsThe median age of the study patients was 59.7 ± 11.7 years, and 84.7% were male. The incidence of LVT was 17.6% (23 patients). While the anterior STEMI rate was 86.9% in the thrombus (+) group, it was 50.9% in the thrombus (-) group (p<0.001). While WMSI was 2.1 ± 0.44 in the thrombus (+) group, it was calculated as 1.40 ± 0.31 in the thrombus (-) group (p<0.001). In the thrombus (+) group, EF was found to be lower, end-systolic and end-diastolic volumes were higher, and the rate of moderate and severe mitral regurgitation and the rate of aneurysmatic segment detection were higher. LVT had a moderate correlation with WMSI (r: 0.613; p<0.001), the presence of an aneurysmatic segment (r: 0.549; p<0.001), and EF (r: -0.514; p<0.001). Presentation with anterior STEMI (odds ratio [OR]: 4.266; p<0.001), WMSI (OR: 7.971; p=0.012), the number of leads with pathological Q waves detected at discharge (OR: 3.651; p=0.009), the presence of an aneurysmatic segment (OR: 2.089, p=0.009), and EF (OR: 1.129, p=0.006) were identified as independent risk factors of the presence of LVT. The area under the curve for WMSI was found to be 0.910 (95% CI: 0.852-0.968). A WMSI cut-off of 1.56 identified LVT with 91% sensitivity and 70% specificity (Youden index: 0.617). ConclusionIn the primary PCI era, LVT incidence after acute STEMI is still significant. Anterior STEMI, the number of leads with pathological Q waves detected at discharge, WMSI, aneurysm formation, and low EF are independent risk factors for LVT. Among these risk factors, the variable with the highest diagnostic power is WMSI.

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Impact of Q-wave regression on clinical outcomes after primary percutaneous coronary intervention in anterior STEMI: A case series

Bouchaala,

Yassini,

Kasmi

et al. 2024

IHJ Cardiovascular Reports

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Regression of Q waves and clinical outcomes following primary PCI in anterior STEMI

Cited by 3 publications

References 28 publications

Prognostic value of initial QRS analysis in anterior STEMI: Correlation with left ventricular systolic dysfunction, serum biomarkers, and cardiac outcomes

Prognostic value of initial QRS analysis in anterior STEMI: Correlation with left ventricular systolic dysfunction, serum biomarkers, and cardiac outcomes

Incidence and Predictors of Left Ventricular Thrombus Formation After Acute Myocardial Infarction With ST-Segment Elevation

Impact of Q-wave regression on clinical outcomes after primary percutaneous coronary intervention in anterior STEMI: A case series

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