Roles of Morris Index on Poor Outcomes in Patients with Non-ST Segment Elevation Acute Coronary Syndrome
Huizhong Lin1, Tao Lin2, Lan Lin1
1Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China (mainland).
Insights
The Morris index, or P wave terminal force in lead V1 (PTFV1), can predict poor outcomes in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients. Elevated PTFV1 at discharge or during hospitalization indicates higher risk.
Area of Science:
- Cardiology
- Electrocardiography
- Acute Coronary Syndromes
Background:
- Non-ST segment elevation acute coronary syndrome (NSTE-ACS) poses significant risks.
- Predictive markers for poor outcomes in NSTE-ACS are crucial for patient management.
Purpose of the Study:
- To evaluate the Morris index (P wave terminal force in lead V1, PTFV1) as a predictor of poor outcomes in NSTE-ACS patients.
- To assess the prognostic value of PTFV1 measurements at admission and discharge.
Main Methods:
- Included 905 patients diagnosed with NSTE-ACS.
- Measured PTFV1 at admission and discharge, categorizing patients into four groups based on positive (+) or negative (-) values.
- Employed univariate and multivariate regression analyses to identify risk factors.
Main Results:
- Patients with PTFV1 (+) at discharge or throughout hospitalization showed significantly higher incidences of poor outcomes.
- The PTFV1 (-)/(+) and PTFV1 (+)/(+) groups had markedly increased hazard ratios for adverse events.
- No significant difference in poor outcomes was observed for the PTFV1 (+)/(-) group.
Conclusions:
- Sustained or discharge-defined PTFV1 positivity are independent risk factors for poor outcomes in NSTE-ACS.
- The Morris index offers valuable prognostic information for NSTE-ACS patients.
- This index may aid in stratifying risk and guiding treatment decisions.
Abstract:
BACKGROUND This study aimed to assess the roles of the Morris index in predicting poor outcomes in patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS). MATERIAL AND METHODS This study included 905 patients with newly diagnosed NSTE-ACS. The Morris index, also known as P wave terminal force in lead V1 (PTFV1), was recorded at admission and discharge. PTVF1 (+) was defined as an absolute value >0.04 mm·s, while PTFV1 (-) was defined as an absolute value <0.04 mm·s. Based on their PTFV1 values at admission/discharge, patients were divided into 4 groups: PTFV1 (-)/(-), PTFV1 (+)/(-), PTFV1 (-)/(+), and PTFV1 (+)/(+). Univariate and multivariate regression analyses were utilized to identify the variables that could contribute to NSTE-ACS risk. RESULTS Compared with the PTFV1 (-)/(-) group, the incidence of poor outcomes was significantly higher in the PTFV1 (-)/(+) (hazard ratio [HR], 3.548; 95% confidence interval [95% CI], 2.024-6.219) and PTFV1 (+)/(+) (HR, 2.133; 95% CI, 1.141-3.986) groups, but not statistically different in the PTFV1 (+)/(-) group (risk ratio, 0.983; 95% CI, 0.424-2.277). CONCLUSIONS Primary PTFV1 (+) at discharge and PTFV1 (+) during hospitalization were independent risk factors for poor outcomes, which may provide useful prognostic information for patients with NSTE-ACS.
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