Ali Nizami Elmas, Halil Fedai, Kenan Toprak, Mustafa Begenç Taşcanov, İbrahim Halil Altıparmak, Asuman Biçer, Recep Demirbağ, Zülkif Tanrıverdi
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Six parameters comprised ERS: pulse rate >75, left ventricular hypertrophy according to Sokolow-Lyon criteria, QRS transition zone ≥V4, corrected QT (QTc) interval >450 for men and >460 for women, T peak to T end interval (Tp-e) >89 ms, and frontal QRS-T angle >90°. The ERS was calculated according to the number of abnormal findings in electrocardiogram. The study population was divided into 2 groups as ERS <3 and ≥3.</p><p><strong>Results: </strong>No significant difference was found between ERS ≥3 and <3 groups in terms of demographic characteristics. However, patients with ERS ≥3 had significantly higher maximum troponin (P < .001), thrombolysis in myocardial infarction (P = .002), and global registry of acute coronary events (P < .001) risk scores and 3-vessel disease frequency (P = .001), whereas they had lower left ventricular ejection fraction (P < .001). These patients also had higher frequency of in-hospital mortality (P < .001) and adverse events. Multiple logistic regression analysis demonstrated that ERS (OR = 1.790, 95% CI: 1.036-3.095, P = .037) was an independent predictor of in-hospital mortality.</p><p><strong>Conclusion: </strong>The frequency of in-hospital adverse events and mortality was significantly higher in NSTEMI patients with an ERS ≥3 at admission. 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引用次数: 0
摘要
背景：急性冠状动脉综合征是导致全球死亡的主要原因。电风险评分（ERS）是一种新型心电图风险评分系统。ERS对非ST段抬高型心肌梗死（NSTEMI）患者预后的重要性尚不清楚。我们旨在确定接受冠状动脉造影术（CAG）的 NSTEMI 患者的 ERS 与院内预后的关系：本研究共纳入了 427 名连续接受冠状动脉造影术（CAG）的 NSTEMI 患者。ERS由六个参数组成：脉搏率>75、左心室肥厚（根据Sokolow-Lyon标准）、QRS过渡区≥V4、校正QT（QTc）间期男性>450，女性>460、T峰至T终间期（Tp-e）>89 ms、额QRS-T角>90°。ERS 根据心电图异常结果的数量计算。研究对象按 ERS 结果分为两组：ERS≥3组与结论组无明显差异：入院时 ERS≥3 的 NSTEMI 患者发生院内不良事件和死亡率的频率明显更高。这一简单的心电图风险标志物可帮助识别NSTEMI患者中心脏风险较高的患者，并识别可能需要早期冠状动脉介入治疗的患者。
The Association of Electrical Risk Score with Prognosis in Patients with Non-ST Elevation Myocardial Infarction Undergoing Coronary Angiography.
Background: Acute coronary syndromes are the leading cause of mortality worldwide. Electrical risk score (ERS) is a novel electrocardiographic risk scoring system. The prognostic importance of ERS in non-ST elevation myocardial infarction (NSTEMI) patients is unknown. We aimed to determine the association of ERS with in-hospital prognosis in NSTEMI patients undergoing coronary angiography (CAG).
Methods: A total of 427 consecutive NSTEMI patients undergoing CAG were enrolled in this study. Six parameters comprised ERS: pulse rate >75, left ventricular hypertrophy according to Sokolow-Lyon criteria, QRS transition zone ≥V4, corrected QT (QTc) interval >450 for men and >460 for women, T peak to T end interval (Tp-e) >89 ms, and frontal QRS-T angle >90°. The ERS was calculated according to the number of abnormal findings in electrocardiogram. The study population was divided into 2 groups as ERS <3 and ≥3.
Results: No significant difference was found between ERS ≥3 and <3 groups in terms of demographic characteristics. However, patients with ERS ≥3 had significantly higher maximum troponin (P < .001), thrombolysis in myocardial infarction (P = .002), and global registry of acute coronary events (P < .001) risk scores and 3-vessel disease frequency (P = .001), whereas they had lower left ventricular ejection fraction (P < .001). These patients also had higher frequency of in-hospital mortality (P < .001) and adverse events. Multiple logistic regression analysis demonstrated that ERS (OR = 1.790, 95% CI: 1.036-3.095, P = .037) was an independent predictor of in-hospital mortality.
Conclusion: The frequency of in-hospital adverse events and mortality was significantly higher in NSTEMI patients with an ERS ≥3 at admission. This simple electrocardiographic risk marker may help identify patients at higher cardiac risk in patients presenting with NSTEMI and identify patients who may need early coronary intervention.
期刊介绍：
The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English.
The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology.
The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
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