PMID- 31571793
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220410
IS  - 1011-6842 (Print)
IS  - 1011-6842 (Linking)
VI  - 35
IP  - 5
DP  - 2019 Sep
TI  - Terminal QRS Distortion in ST Elevation Myocardial Infarction as a Prediction of 
      Mortality: Systematic Review and Meta-Analysis.
PG  - 445-458
LID - 10.6515/ACS.201909_35(5).20180909A [doi]
AB  - BACKGROUND: Terminal QRS distortion reflects advanced stage and large myocardial 
      infarction predisposing the heart to adverse outcomes. Recent studies suggest 
      that terminal QRS distortion is associated with morbidity and mortality in ST 
      elevation myocardial infarction (STEMI). However, a systematic review and 
      meta-analysis of the literature have not been done. OBJECTIVE: We assessed the 
      association between terminal QRS distortion in patients with STEMI and mortality 
      by a systematic review of the literature and a meta-analysis. METHODS: We 
      comprehensively searched the databases of MEDLINE and EMBASE from inception to 
      September 2017. Included studies were published prospective or retrospective 
      cohort studies that compared all-cause mortality in subjects with STEMI with QRS 
      distortion versus those without QRS distortion. Data from each study were 
      combined using the random-effects, generic inverse variance method of DerSimonian 
      and Laird to calculate risk ratios and 95% confidence intervals. RESULTS: Fifteen 
      studies from January 1993 to May 2015 were included in this meta-analysis 
      involving 7,479 subjects with STEMI (2,906 QRS distortion and 4,573 non-QRS 
      distortion). QRS distortion was associated with increased mortality (pooled risk 
      ratio = 1.81, 95% confidence interval: 1.37-2.40, p < 0.000, I(2) = 41.6%). 
      Considering the introduction of clopidogrel in 2004, we performed subgroup 
      analyses before and after 2004, and the associated with higher mortality was 
      still present (before 2004, RR 1.75, 95% CI 1.08-2.82, p = 0.022, I(2) = 66.1%; 
      after 2004, RR 1.96, 95% CI 1.44-2.65, p < 0.001, I(2) = 0%). CONCLUSIONS: 
      Terminal QRS distortion increased all-cause mortality by 81%. Our study suggests 
      that terminal QRS distortion is an important tool to assess the risk in patients 
      with STEMI.
FAU - Prasitlumkum, Narut
AU  - Prasitlumkum N
AD  - University of Hawaii Internal Medicine Residency Program, Honolulu, HI.
FAU - Sirinvaravong, Natee
AU  - Sirinvaravong N
AD  - Department of Medicine, Einstein Medical Center, Philadelphia, PA, USA.
FAU - Limpruttidham, Nath
AU  - Limpruttidham N
AD  - University of Hawaii Internal Medicine Residency Program, Honolulu, HI.
FAU - Rattanawong, Pattara
AU  - Rattanawong P
AD  - University of Hawaii Internal Medicine Residency Program, Honolulu, HI.
AD  - Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
FAU - Tom, Elysse
AU  - Tom E
AD  - University of Hawaii Internal Medicine Residency Program, Honolulu, HI.
FAU - Kanitsoraphan, Chanavuth
AU  - Kanitsoraphan C
AD  - Faculty of Medicine Siriraj Hospital.
FAU - Chongsathidkiet, Pakawat
AU  - Chongsathidkiet P
AD  - Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
AD  - Department of Pathology, Duke University Medical Center, Durham, North Carolina, 
      USA.
FAU - Boondarikpornpant, Thosaporn
AU  - Boondarikpornpant T
AD  - Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 
      Thailand.
LA  - eng
PT  - Journal Article
PL  - China (Republic : 1949- )
TA  - Acta Cardiol Sin
JT  - Acta Cardiologica Sinica
JID - 101687085
PMC - PMC6760130
OTO - NOTNLM
OT  - Mortality
OT  - ST elevation
OT  - Terminal QRS distortion
EDAT- 2019/10/02 06:00
MHDA- 2019/10/02 06:01
PMCR- 2019/09/01
CRDT- 2019/10/02 06:00
PHST- 2019/10/02 06:00 [entrez]
PHST- 2019/10/02 06:00 [pubmed]
PHST- 2019/10/02 06:01 [medline]
PHST- 2019/09/01 00:00 [pmc-release]
AID - 10.6515/ACS.201909_35(5).20180909A [doi]
PST - ppublish
SO  - Acta Cardiol Sin. 2019 Sep;35(5):445-458. doi: 
      10.6515/ACS.201909_35(5).20180909A.