Publication details

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

Authors

HOLICKÁ Mária ČUČKOVÁ Pavla HNATKOVA Katerina KOC Lumír ONDRÚŠ Tomáš LOKAJ Petr PAŘENICA Jiří NOVOTNÝ Tomáš KALA Petr MALÍK Marek

Year of publication 2021
Type Article in Periodical
Magazine / Source Diagnostics
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.mdpi.com/2075-4418/11/5/799
Doi http://dx.doi.org/10.3390/diagnostics11050799
Keywords primary percutaneous coronary intervention; Q wave; Selvester score; ST elevation myocardial infarction
Description 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.
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