Prediction of Successful Reperfusion in ST-Elevation Myocardial Infarction Patients Following Thrombolytic Treatment or Primary PCI Using Modified Selvester QRS Score.

Shereef, Ahmed Shawky; Shaker, Ahmed; Shehata, Islam Elsayed

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.

Zagazig University Medical Journal, 2023, Vol 29, Issue 5, p1218

1110-1431

Academic Journal

10.21608/ZUMJ.2022.133190.2551