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首页> 外文期刊>Circulation journal >High QRS score on admission strongly predicts impaired myocardial reperfusion in patients with a first anterior acute myocardial infarction.
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High QRS score on admission strongly predicts impaired myocardial reperfusion in patients with a first anterior acute myocardial infarction.

机译：入院时QRS评分高，强烈预示着急性前发性心肌梗死患者的心肌再灌注受损。

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摘要

BACKGROUND: In patients with acute myocardial infarction (AMI), QRS score at presentation electrocardiogram (ECG) may reflect the evolutionary stage of the infarction and allow one to predict the degree of myocardial reperfusion potentially achievable by reperfusion therapy. METHODS AND RESULTS: The relationship between QRS score on admission ECG and myocardial blush grade, an angiographic marker of myocardial reperfusion, was examined in 416 patients with a first anterior AMI who received reperfusion therapy within 6h after symptom onset. Patients were classified into 3 groups according to QRS score: 0 or 1 (n=102), 2-4 (n=228), and >/=5 (n=86). Higher QRS scores were associated with a longer time to admission, a greater ST-segment elevation, a higher frequency of impaired initial and final culprit coronary vessel flow, a higher peak creatine kinase level, and a higher frequency of impaired myocardial reperfusion as defined by myocardial blush grade 0/1 on the final angiogram. Multivariate analysis showed that a high QRS score >/=5 was the strongest predictor of impaired myocardial reperfusion (odds ratio 20.3, P<0.001). These findings were similar when the data were stratified according to time to admission (2h). CONCLUSIONS: In patients with a first anterior AMI treated by reperfusion therapy, admission high QRS score >/=5 strongly predicts impaired myocardial reperfusion, even when presentation is early (
机译：背景：在患有急性心肌梗塞（AMI）的患者中，表现心电图（ECG）的QRS评分可能反映了梗塞的演变阶段，并允许人们预测通过再灌注治疗可能实现的心肌再灌注程度。方法和结果：检查了416例初发急性前AMI患者，其在症状发作后6小时内接受了再灌注治疗，检查了入院ECG QRS评分与心肌腮红评分（心肌再灌注血管造影指标）之间的关系。根据QRS评分将患者分为3组：0或1（n = 102），2-4（n = 228）和> / = 5（n = 86）。 QRS分数越高，则入院时间越长，ST段抬高程度越高，最初和最终罪魁祸首冠状动脉血流受损的频率越高，肌酸激酶峰值水平越高，心肌再灌注受损的频率越高，最终血管造影照片上的心肌腮红等级为0/1。多因素分析显示，QRS评分高> / = 5是心肌再灌注受损的最强预测因子（几率20.3，P <0.001）。当根据入院时间（ 2h）对数据进行分层时，这些发现是相似的。结论：在通过再灌注疗法治疗的第一个前部AMI患者中，入院QRS高分> / = 5强烈预示着心肌再灌注受损，即使提早出现（

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