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

Document Type : Original Article

Authors

1 Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig 44519, Egypt.

2 Assistant 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.

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Zagazig University Medical Journal
Volume 29, Issue 5
September and October 2023
Pages 1218-1226

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