Prediction of Successful Reperfusion in ST-Elevation Myocardial Infarction Patients Following Thrombolytic Treatment or Primary PCI Using Modified Selvester QRS Score | ||
| Zagazig University Medical Journal | ||
| Article 2, Volume 29, Issue 5, September and October 2023, Pages 1218-1226 PDF (625.73 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2022.133190.2551 | ||
| Authors | ||
| Ahmed Shereef1; Ahmed Shaker2; Islam Shehata* 1 | ||
| 1Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt. | ||
| 2Assistant Professor of Cardiology, Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt. | ||
| Abstract | ||
| Background: The purpose of this study was to see if the modified Selvester QRS score might predict ST-segment resolution in individuals who had their first acute STEMI following thrombolytic treatment or primary PCI. Methods: The research included 122 people who had had an acute STEMI. 91 patients received thrombolysis, 31 received primary PCI, and all were subjected to 12-lead ECGs with estimation of the modified Selvester QRS score and the sum of ST-elevation (STE), as well as echocardiographic evaluation to measure LV ejection fraction (EF) and wall motion score index (WMSI), as well as coronary angiography. Results: Patients with a QRS score more than 4 had significantly worse EF, longer time to admission, fewer patients without ST-segment resolution, higher WMSI, fewer patients with myocardial blush grade (MBG) 3, more patients with MBG 1, and more patients with three-vessel disease than patients with a QRS score less than 4. QRS score 4 predicts ST-segment resolution ≥50% with a 59.3% sensitivity, 100% specificity, an 86% negative predictive value, a 62.1 percent positive predictive value, and a 75.6% total accuracy. ST-segment resolution was negatively correlated with the QRS score (r = -0.483, p = 0.00078). Conclusions: The Selvester QRS score method may give useful information on the myocardium at risk, the prognosis of residual left ventricular function, and the selection of therapy. | ||
| Keywords | ||
| ST-segment elevation myocardial infarction; Reperfusion; Modified Selvester score, primary PCI, Thrombolysis | ||
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