PMID- 24407536
OWN - NLM
STAT- MEDLINE
DCOM- 20150915
LR  - 20211021
IS  - 2213-3763 (Electronic)
IS  - 0019-4832 (Print)
IS  - 0019-4832 (Linking)
VI  - 65
IP  - 6
DP  - 2013 Dec
TI  - Prognostic significance of the distortion of terminal portion of QRS complex on 
      admission electrocardiogram in ST segment elevation myocardial infarction.
PG  - 671-7
LID - S0019-4832(13)00331-3 [pii]
LID - 10.1016/j.ihj.2013.10.012 [doi]
AB  - BACKGROUND: ECG on admission has been used in predicting prognosis and risk 
      stratification in ST segment elevation acute myocardial infarction (STEMI). 
      OBJECTIVE: To analyze the admission ECG in STEMI based on abnormality observed in 
      terminal portion of QRS and its correlation to hospital mortality. METHOD: 160 
      consecutive patients of STEMI were classified into subjects without (Group I) and 
      with distortion of terminal QRS (Group II), Pattern A--Emergence of J point at 
      >/=50% of the R wave amplitude in leads with qR configuration or Pattern B--Absence 
      of the S waves, in leads with Rs configuration in two consecutive leads. RESULTS: 
      Out of 160 patients of STEMI, 69 (43.1%) had distortion of QRS. There were 13 
      deaths (8.1%). Hospital mortality was found to be significantly more in subjects 
      with distortion than those without (15.9% V/S 2.1%, p < 0.001). Patients with QRS 
      distortion tended to have larger infarction as assessed by Killip class on 
      admission (p < 0.05), anterior location of MI (p < 0.01) and presence of 
      significant Q waves in leads with ST segment elevation (p < 0.0001). With 
      multiple logistic regression analysis using hospital mortality as a dependent 
      variable and all studied risk factors as independent variables, QRS distortion on 
      admission ECG was the only variable found to be statistically significant 
      (Adjusted OR = 7.161, p < 0.05). CONCLUSION: ECG on admission is a simple, cheap, 
      universally available investigation that can predict the short term prognosis in 
      STEMI and would help in deciding which patients should go for other myocardial 
      revascularization procedures.
CI  - Copyright (c) 2013 Cardiological Society of India. Published by Elsevier B.V. All 
      rights reserved.
FAU - Mulay, Dnyaneshwar V
AU  - Mulay DV
AD  - Department of Medicine, Government Medical College, Aurangabad 431001, 
      Maharashtra, India. Electronic address: mulay.dv@gmail.com.
FAU - Mukhedkar, Sachin M
AU  - Mukhedkar SM
AD  - Department of Medicine, Government Medical College, Aurangabad 431001, 
      Maharashtra, India.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20131101
PL  - India
TA  - Indian Heart J
JT  - Indian heart journal
JID - 0374675
SB  - IM
MH  - Adult
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - *Cause of Death
MH  - Cohort Studies
MH  - Electrocardiography/*methods
MH  - Female
MH  - *Hospital Mortality
MH  - Humans
MH  - India
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/*diagnosis/*mortality/therapy
MH  - Patient Admission/*statistics & numerical data
MH  - Prognosis
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
MH  - Sex Factors
MH  - Survival Analysis
PMC - PMC3905251
OTO - NOTNLM
OT  - AMI
OT  - ECG changes
OT  - Prognosis
EDAT- 2014/01/11 06:00
MHDA- 2015/09/16 06:00
PMCR- 2013/12/01
CRDT- 2014/01/11 06:00
PHST- 2012/12/22 00:00 [received]
PHST- 2013/08/12 00:00 [revised]
PHST- 2013/10/09 00:00 [accepted]
PHST- 2014/01/11 06:00 [entrez]
PHST- 2014/01/11 06:00 [pubmed]
PHST- 2015/09/16 06:00 [medline]
PHST- 2013/12/01 00:00 [pmc-release]
AID - S0019-4832(13)00331-3 [pii]
AID - 10.1016/j.ihj.2013.10.012 [doi]
PST - ppublish
SO  - Indian Heart J. 2013 Dec;65(6):671-7. doi: 10.1016/j.ihj.2013.10.012. Epub 2013 
      Nov 1.