The Role of QRS Complex and ST-Segment in Major Adverse Cardiovascular Events Prediction in Patients with ST Elevated
Srđan Maletin1,2, Milovan Petrović1,2, Anastazija Stojšić-Milosavljević1,2
1Faculty of Medicine, University of Novi Sad, 21000 Novi Sad, Serbia.
Insights
Wider QRS complex and higher ST-segment elevation in ST-segment elevation myocardial infarction (STEMI) patients predict major adverse cardiovascular events (MACE) after percutaneous coronary intervention (PCI). These ECG markers indicate longer ischemic times and increased long-term MACE risk.
Area of Science:
- Cardiology
- Electrocardiography
- Myocardial Infarction
Background:
- ST-segment elevation myocardial infarction (STEMI) patients often experience major adverse cardiovascular events (MACE) post-percutaneous coronary intervention (PCI).
- Predictive markers for MACE in STEMI patients are crucial for risk stratification and management.
Purpose of the Study:
- To investigate the predictive value of QRS complex width and ST-segment elevation for MACE in STEMI patients undergoing PCI.
- To assess the association of these electrocardiogram (ECG) parameters with symptom duration and long-term outcomes.
Main Methods:
- A cohort of 200 PCI-treated STEMI patients was analyzed, divided into symptom duration groups (<6h and 6-12h).
- ECGs were recorded at six time points, and patients were followed for up to six years for MACE.
- Statistical analysis identified independent predictors of MACE.
Main Results:
- The 6-12h symptom duration group exhibited wider QRS complexes, higher ST-segment elevation, and lower ST-segment resolution.
- Wider QRS complexes and greater ST-segment elevation were significant independent predictors of MACE at all time points (p < 0.05).
- These ECG parameters remained significant predictors even after adjusting for myocardial injury biomarkers.
Conclusions:
- Wider QRS complex and pronounced ST-segment elevation are linked to longer ischemic times in STEMI patients.
- These ECG findings are associated with an increased risk of long-term MACE following PCI.
- ECG parameters like QRS width and ST-segment elevation offer valuable prognostic information in STEMI management.
Background:
as a relatively high number of ST-segment elevation myocardial infarction (STEMI) patients develop major adverse cardiovascular events (MACE) following percutaneous coronary intervention (PCI), our aim was to determine the significance, and possible predictive value of QRS complex width and ST-segment elevation.
Methods:
our patient sample included 200 PCI-treated STEMI patients, which were divided into two groups based on the following duration of symptoms: (I) less than 6 h, and (II) 6 to 12 h. For every patient, an ECG was performed at six different time points, patients were followed for up to six years for the occurrence of MACE.
Results:
the mean age was 60.6 ± 11.39 years, and 142 (71%) were male. The 6-12 h group had significantly wider QRS complex, higher ST-segment elevation, lower prevalence of ST-segment resolution as well as MACE prevalence (p < 0.05). ECG parameters, QRS width, and magnitude of ST-segment elevation were proved to be independent significant predictors of MACE in all measured time points (p < 0.05). Even after controlling for biomarkers of myocardial injury, these ECG parameters remained statistically significant predictors of MACE (p < 0.05).
Conclusion:
our study highlights that wider QRS complex and a more pronounced ST-segment elevation are associated with longer total ischemic time and higher risk of long-term MACE.
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