A correlation study between precordial QRS complex characteristics and the prognosis of patients with acute anterior ST-segment elevation myocardial infarction treated by percutaneous coronary intervention
LI Xiao-tao
CHEN Xiao-jie
LIANG Chun-ling
ZHANG Ran
YANG Yu-hong
HUANG Chao-lian
YANG Da-wei
Abstract：Objective To explore the risk characteristics of precordial QRS complexes with the prognosis of patients undergoing percutaneous coronary intervention(PCI)for acute anterior ST-segment elevation myocardial infarction(STEMI)and to develop a risk scoring model based on these precordial QRS complex characteristics.Methods A total of 273 patients with acute anterior STEMI treated by PCI at Wangjing Hospital of China Academy of Chinese Medicine Sciences from January 2016 to June 2019 were selected.The primary outcome measure was major adverse cardiac events(MACE)during the follow-up period.Cox regression models were employed to identify risk predictors based on the precordial QRS complex characteristics at discharge and to establish a risk scoring model.Results Among the 273 patients,the incidence of MACE was 20.15%(55 cases),and the average follow-up time was(24.25±3.91)months.Cox regression analysis revealed that the following precordial QRS complex characteristics were predictive of MACE occurrence:QRS duration(HR=1.043,95%CI 1.025-1.061,P<0.001),presence of Q wave(HR=2.078,95%CI 1.148-3.762,P=0.016),presence of fragmented QRS wave(HR=1.955,95%CI 1.121-3.409,P=0.018),cumulative number of precordial leads≥3(HR=2.728,95%CI 1.409-5.282,P=0.003),cumulative sum of precordial lead R wave amplitudes(HR=0.973,95%CI 0.955-0.992,P=0.005),ratio of cumulative sum of precordial lead R wave amplitudes to(S wave + Q wave)amplitudes[R/(Q + S)](HR=0.291,95%CI 0.118-0.715,P=0.007).Based on these findings,a risk scoring model was developed,which demonstrated good accuracy with an area under the curve(AUC)of 0.722 for predicting MACE.Conclusion The risk scoring model based on precordial QRS complex characteristics shows promise in predicting the prognosis of patients with acute anterior STEMI undergoing PCI.
Keywords：Percutaneous coronary interventionAcute anterior ST-segment elevation myocardial infarctionMajor adverse cardiac eventRisk score model
Publication Date：2024-01-10
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 60-65 )