PMID- 33925108 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20240214 IS - 2075-4418 (Print) IS - 2075-4418 (Electronic) IS - 2075-4418 (Linking) VI - 11 IP - 5 DP - 2021 Apr 28 TI - In Comparison to Pathological Q Waves, Selvester Score is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention. LID - 10.3390/diagnostics11050799 [doi] LID - 799 AB - The development of pathological Q waves has long been correlated with worsened outcome in patients with ST elevation myocardial infarction (STEMI). In this study, we investigated long-term mortality of STEMI patients treated by primary percutaneous coronary intervention (PPCI) and compared predictive values of Q waves and of Selvester score for infarct volume estimation. Data of 283 consecutive STEMI patients (103 females) treated by PPCI were analysed. The presence of pathological Q wave was evaluated in pre-discharge electrocardiograms (ECGs) recorded >/=72 h after the chest pain onset (72 h Q). The Selvester score was evaluated in acute ECGs (acute Selvester score) and in the pre-discharge ECGs (72 h Selvester score). The results were related to total mortality and to clinical and laboratory variables. A 72 h Q presence and 72 h Selvester score >/=6 was observed in 184 (65.02%) and 143 (50.53%) patients, respectively. During a follow-up of 5.69 +/- 0.66 years, 36 (12.7%) patients died. Multivariably, 72 h Selvester score >/=6 was a strong independent predictor of death, while a predictive value of the 72 h Q wave was absent. In high-risk subpopulations defined by clinical and laboratory variables, the differences in total mortality were highly significant (p < 0.01 for all subgroups) when stratified by 72 h Selvester score >/=6. On the contrary, the additional risk-prediction by 72 h Q presence was either absent or only borderline. In contemporarily treated STEMI patients, Selvester score is a strong independent predictor of long-term all-cause mortality. On the contrary, the prognostic value of Q-wave presence appears limited in contemporarily treated STEMI patients. FAU - Holicka, Maria AU - Holicka M AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Cuckova, Pavla AU - Cuckova P AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Hnatkova, Katerina AU - Hnatkova K AD - National Heart and Lung Institute, Imperial College of London, 72 Du Cane Rd, Shepherd's Bush, London W12 0NN, UK. FAU - Koc, Lumir AU - Koc L AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Ondrus, Tomas AU - Ondrus T AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Lokaj, Petr AU - Lokaj P AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Parenica, Jiri AU - Parenica J AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Novotny, Tomas AU - Novotny T AUID- ORCID: 0000-0002-0292-4034 AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Kala, Petr AU - Kala P AD - Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic. AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. FAU - Malik, Marek AU - Malik M AUID- ORCID: 0000-0002-3792-1407 AD - Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic. AD - National Heart and Lung Institute, Imperial College of London, 72 Du Cane Rd, Shepherd's Bush, London W12 0NN, UK. LA - eng GR - NH/16/2/32499/BHF_/British Heart Foundation/United Kingdom GR - New Horizons Grant NH/16/2/32499/BHF_/British Heart Foundation/United Kingdom PT - Journal Article DEP - 20210428 PL - Switzerland TA - Diagnostics (Basel) JT - Diagnostics (Basel, Switzerland) JID - 101658402 PMC - PMC8146038 OTO - NOTNLM OT - Q wave OT - ST elevation myocardial infarction OT - Selvester score OT - primary percutaneous coronary intervention COIS- The authors have no relationships relevant to the contents of this manuscript. EDAT- 2021/05/01 06:00 MHDA- 2021/05/01 06:01 PMCR- 2021/04/28 CRDT- 2021/04/30 01:30 PHST- 2021/03/21 00:00 [received] PHST- 2021/04/14 00:00 [revised] PHST- 2021/04/26 00:00 [accepted] PHST- 2021/04/30 01:30 [entrez] PHST- 2021/05/01 06:00 [pubmed] PHST- 2021/05/01 06:01 [medline] PHST- 2021/04/28 00:00 [pmc-release] AID - diagnostics11050799 [pii] AID - diagnostics-11-00799 [pii] AID - 10.3390/diagnostics11050799 [doi] PST - epublish SO - Diagnostics (Basel). 2021 Apr 28;11(5):799. doi: 10.3390/diagnostics11050799.