Determinants and prognostic implications of terminal QRS complex distortion in patients treated with primary angioplasty for acute myocardial infarction

Cheol Whan Lee, Myeong Ki Hong, Hyun Suk Yang, Si Wan Choi, Jae Joong Kim, Seong Wook Park, Seung Jung Park

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Terminal QRS complex distortion on admission has an impact on a patient's prognosis after primary angioplasty for acute myocardial infarction (AMI). We evaluated the determinants and prognostic significance of terminal QRS complex distortion in 153 consecutive patients with AMI after primary angioplasty. The study population was divided into 2 groups according to the presence (group I, n = 41) or absence (group II, n = 112) of terminal QRS complex distortion. The primary end points were the occurrence, within 6 weeks after AMI, of death, nonfatal reinfarction, or congestive heart failure. Baseline characteristics were similar between the 2 groups. However, patients in group I had higher peak levels of serum creatine kinase than those in group II (5,100 ± 3,100 vs 3,000 ± 1,800 U/L, respectively, p <0.01). The rate of angiographic no-reflow (Thrombolysis In Myocardial Infarction flow grade ≤2) was 31.7% in group I and 10.7% in group II (p <0.01). The predischarge left ventricular ejection fraction was 45.0 ± 12.0% in group I and 54.0 ± 8.0% in group II (p <0.01). Multivariate analysis identified the pressure-derived fractional collateral flow index and the culprit lesion in the left anterior descending coronary artery as independent determinants of the terminal QRS complex distortion. No patients died during 6 weeks of follow-up. The 2 groups were similar for life-threatening arrhythmia or reinfarction. However, there were more patients in group I than in group II with congestive heart failure (26.8% vs 5.4%, respectively, p <0.01) or who reached the primary end points (29.3% vs 5.4%, respectively, p <0.01). In conclusion, terminal QRS complex distortion on admission is associated with poor clinical outcome after primary angioplasty for AMI, and collateral flow may have a major influence on terminal QRS complex distortion during AMI.

Original languageEnglish
Pages (from-to)210-213
Number of pages4
JournalAmerican Journal of Cardiology
Volume88
Issue number3
DOIs
Publication statusPublished - 2001 Aug 1

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Angioplasty
Myocardial Infarction
Heart Failure
Creatine Kinase
Stroke Volume
Cardiac Arrhythmias
Coronary Vessels
Multivariate Analysis
Pressure
Serum
Population

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Cheol Whan ; Hong, Myeong Ki ; Yang, Hyun Suk ; Choi, Si Wan ; Kim, Jae Joong ; Park, Seong Wook ; Park, Seung Jung. / Determinants and prognostic implications of terminal QRS complex distortion in patients treated with primary angioplasty for acute myocardial infarction. In: American Journal of Cardiology. 2001 ; Vol. 88, No. 3. pp. 210-213.
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title = "Determinants and prognostic implications of terminal QRS complex distortion in patients treated with primary angioplasty for acute myocardial infarction",
abstract = "Terminal QRS complex distortion on admission has an impact on a patient's prognosis after primary angioplasty for acute myocardial infarction (AMI). We evaluated the determinants and prognostic significance of terminal QRS complex distortion in 153 consecutive patients with AMI after primary angioplasty. The study population was divided into 2 groups according to the presence (group I, n = 41) or absence (group II, n = 112) of terminal QRS complex distortion. The primary end points were the occurrence, within 6 weeks after AMI, of death, nonfatal reinfarction, or congestive heart failure. Baseline characteristics were similar between the 2 groups. However, patients in group I had higher peak levels of serum creatine kinase than those in group II (5,100 ± 3,100 vs 3,000 ± 1,800 U/L, respectively, p <0.01). The rate of angiographic no-reflow (Thrombolysis In Myocardial Infarction flow grade ≤2) was 31.7{\%} in group I and 10.7{\%} in group II (p <0.01). The predischarge left ventricular ejection fraction was 45.0 ± 12.0{\%} in group I and 54.0 ± 8.0{\%} in group II (p <0.01). Multivariate analysis identified the pressure-derived fractional collateral flow index and the culprit lesion in the left anterior descending coronary artery as independent determinants of the terminal QRS complex distortion. No patients died during 6 weeks of follow-up. The 2 groups were similar for life-threatening arrhythmia or reinfarction. However, there were more patients in group I than in group II with congestive heart failure (26.8{\%} vs 5.4{\%}, respectively, p <0.01) or who reached the primary end points (29.3{\%} vs 5.4{\%}, respectively, p <0.01). In conclusion, terminal QRS complex distortion on admission is associated with poor clinical outcome after primary angioplasty for AMI, and collateral flow may have a major influence on terminal QRS complex distortion during AMI.",
author = "Lee, {Cheol Whan} and Hong, {Myeong Ki} and Yang, {Hyun Suk} and Choi, {Si Wan} and Kim, {Jae Joong} and Park, {Seong Wook} and Park, {Seung Jung}",
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Determinants and prognostic implications of terminal QRS complex distortion in patients treated with primary angioplasty for acute myocardial infarction. / Lee, Cheol Whan; Hong, Myeong Ki; Yang, Hyun Suk; Choi, Si Wan; Kim, Jae Joong; Park, Seong Wook; Park, Seung Jung.

In: American Journal of Cardiology, Vol. 88, No. 3, 01.08.2001, p. 210-213.

Research output: Contribution to journalArticle

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AU - Lee, Cheol Whan

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N2 - Terminal QRS complex distortion on admission has an impact on a patient's prognosis after primary angioplasty for acute myocardial infarction (AMI). We evaluated the determinants and prognostic significance of terminal QRS complex distortion in 153 consecutive patients with AMI after primary angioplasty. The study population was divided into 2 groups according to the presence (group I, n = 41) or absence (group II, n = 112) of terminal QRS complex distortion. The primary end points were the occurrence, within 6 weeks after AMI, of death, nonfatal reinfarction, or congestive heart failure. Baseline characteristics were similar between the 2 groups. However, patients in group I had higher peak levels of serum creatine kinase than those in group II (5,100 ± 3,100 vs 3,000 ± 1,800 U/L, respectively, p <0.01). The rate of angiographic no-reflow (Thrombolysis In Myocardial Infarction flow grade ≤2) was 31.7% in group I and 10.7% in group II (p <0.01). The predischarge left ventricular ejection fraction was 45.0 ± 12.0% in group I and 54.0 ± 8.0% in group II (p <0.01). Multivariate analysis identified the pressure-derived fractional collateral flow index and the culprit lesion in the left anterior descending coronary artery as independent determinants of the terminal QRS complex distortion. No patients died during 6 weeks of follow-up. The 2 groups were similar for life-threatening arrhythmia or reinfarction. However, there were more patients in group I than in group II with congestive heart failure (26.8% vs 5.4%, respectively, p <0.01) or who reached the primary end points (29.3% vs 5.4%, respectively, p <0.01). In conclusion, terminal QRS complex distortion on admission is associated with poor clinical outcome after primary angioplasty for AMI, and collateral flow may have a major influence on terminal QRS complex distortion during AMI.

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