Both baseline Selvester QRS score and change in QRS score predict prognosis in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

Abstract

Background: We aimed to demonstrate the prognostic value of Selvester QRS scores in patients with acute ST-segment elevation myocardial infarction (STEMI).

Methods: In this prospective, observational study, we screened 289 patients with acute STEMI who underwent percutaneous coronary intervention (PCI) from 1 January 2014 to 1 June 2015 at the Second Hospital of Dalian Medical University. Selvester QRS scores were calculated at the time of hospital admission and within 24 h after treatment for PCI. The primary endpoint was the 2-year mortality rate, and the secondary endpoint was any nonfatal major adverse cardiovascular event (MACE).

Results: Of the 289 patients, the QRS score increased in 115 (39.8%), and the 2-year mortality and MACE rates were significantly higher in these patients than in those in whom the QRS score decreased or remained unchanged after the treatment of PCI. Multivariable Cox regression analysis revealed that both baseline QRS scores and changes in QRS scores were independently associated with the 2-year mortality rate [hazard ratio (HR) 1.462, 95% confidence interval (95% CI) 1.279-1.671 and HR 5.122, 95% CI 2.128-12.328, respectively), MACE rate (HR 1.119, 95% CI 1.019-1.229 and HR 2.585, 95% CI 1.260-5.303, respectively) and composite endpoint (HR 1.137, 95% CI 1.047-1.236 and HR 3.152, 95% CI 1.704-5.829, respectively) after adjusting for other risk factors.

Conclusion: In conclusion, both baseline Selvester QRS scores and changes in QRS scores independently predicted poor outcomes in patients with acute STEMI who underwent PCI.

Fig. 1

Kaplan–Meier curves for 2-year survival (a), free of non-fetal MACE (b) and free of composite endpoint (c) according to the level of baseline QRS score and ΔQRS score. MACE, major adverse cardiovascular event.