PMID- 31759688
OWN - NLM
STAT- MEDLINE
DCOM- 20210113
LR  - 20210113
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 303
DP  - 2020 Mar 15
TI  - Validation of contemporary electrocardiographic indices of area at risk and 
      infarct size in acute ST elevation myocardial infarction (STEMI).
PG  - 1-7
LID - S0167-5273(19)33112-2 [pii]
LID - 10.1016/j.ijcard.2019.10.041 [doi]
AB  - BACKGROUND: Electrocardiographic (ECG) methods to assess area at risk (AAR) and 
      infarct size (IS) in patients with ST-elevation myocardial infarction (STEMI) 
      have been previously established but not validated against contemporary benchmark 
      Cardiac Magnetic Resonance (CMR) measures. We compared ECG-determined and 
      CMR-determined measures for (a) AAR, (b) IS, and (c) myocardial salvage. METHODS: 
      Sixty patients with ECG evidence of STEMI and CMR imaging performed within 
      13 days were included. The ECG-determined (a) AAR scores (Aldrich and Wilkins), 
      (b) IS (Selvester score), and (c) myocardial salvage (i.e. 
      [AAR-IS] / AAR x 100%), were compared with CMR-determined measures. RESULTS: 
      Compared with CMR-determined AAR, both the Wilkins & Aldrich scores 
      underestimated AAR, although the Wilkins (r = 0.72, p < 0.001) showed a better 
      correlation than the Aldrich (r = 0.54, p < 0.001). Bland-Altman analysis 
      revealed a bias of 2.6% (95% limits of agreement: 18.5%, -13.3%) for the Wilkins 
      and 5.9% (95% limits of agreement: 25.6%, -13.8%) for the Aldrich. Estimation of 
      IS was similar between the Selvester score and CMR, with good correlation 
      (r = 0.77, p < 0.001) and agreement (fixed bias 0.4%, 95% limits of agreement 
      20.8%, -15.5%). However, ECG-determined myocardial salvage significantly 
      underestimated CMR-determined myocardial salvage, with an inverse correlation 
      (r = -0.33, p = 0.01). CONCLUSIONS: The Wilkins score is superior to Aldrich 
      score as an ECG-AAR index, Selvester score is a reasonable ECG estimate of 
      infarct size, though ECG derived myocardial salvage does not have enough accuracy 
      to be used in the clinical setting; it may be an inexpensive surrogate for 
      myocardial salvage in large research studies. Further validation and prognostic 
      studies are required.
CI  - Copyright (c) 2019 Elsevier B.V. All rights reserved.
FAU - Du, Yang Timothy
AU  - Du YT
AD  - Discipline of Medicine, University of Adelaide, Adelaide, South Australia, 
      Australia; Central Adelaide Local Health Network, Adelaide, South Australia, 
      Australia.
FAU - Pasupathy, Sivabaskari
AU  - Pasupathy S
AD  - Discipline of Medicine, University of Adelaide, Adelaide, South Australia, 
      Australia; Central Adelaide Local Health Network, Adelaide, South Australia, 
      Australia.
FAU - Air, Tracy
AU  - Air T
AD  - Discipline of Medicine, University of Adelaide, Adelaide, South Australia, 
      Australia.
FAU - Neil, Christopher
AU  - Neil C
AD  - Department of Medicine, Western Health, University of Melbourne, Melbourne, 
      Australia; Department of Cardiology, Western Health, Melbourne, Australia.
FAU - Beltrame, John F
AU  - Beltrame JF
AD  - Discipline of Medicine, University of Adelaide, Adelaide, South Australia, 
      Australia; Central Adelaide Local Health Network, Adelaide, South Australia, 
      Australia. Electronic address: john.beltrame@adelaide.edu.au.
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20191113
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
SB  - IM
CIN - Int J Cardiol. 2020 Mar 15;303:14-15. PMID: 31882358
MH  - Australia/epidemiology
MH  - Coronary Angiography
MH  - Electrocardiography/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Ventricles/*diagnostic imaging/physiopathology
MH  - Humans
MH  - Magnetic Resonance Imaging, Cine/methods
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/diagnosis/epidemiology/*physiopathology
MH  - Severity of Illness Index
MH  - Survival Rate/trends
COIS- Declaration of competing interest The authors report no relationships that could 
      be construed as a conflict of interest.
EDAT- 2019/11/25 06:00
MHDA- 2021/01/14 06:00
CRDT- 2019/11/25 06:00
PHST- 2019/06/17 00:00 [received]
PHST- 2019/10/16 00:00 [revised]
PHST- 2019/10/24 00:00 [accepted]
PHST- 2019/11/25 06:00 [pubmed]
PHST- 2021/01/14 06:00 [medline]
PHST- 2019/11/25 06:00 [entrez]
AID - S0167-5273(19)33112-2 [pii]
AID - 10.1016/j.ijcard.2019.10.041 [doi]
PST - ppublish
SO  - Int J Cardiol. 2020 Mar 15;303:1-7. doi: 10.1016/j.ijcard.2019.10.041. Epub 2019 
      Nov 13.