Comparison of the prognostic role of Q waves and inverted T waves in the presenting ECG of STEMI patients

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http://hdl.handle.net/10138/309289

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Koivula , K , Nikus , K , Viikilä , J , Lilleberg , J , Huhtala , H , Birnbaum , Y & Eskola , M 2019 , ' Comparison of the prognostic role of Q waves and inverted T waves in the presenting ECG of STEMI patients ' , Annals of Noninvasive Electrocardiology , vol. 24 , no. 1 , 12585 . https://doi.org/10.1111/anec.12585

Title: Comparison of the prognostic role of Q waves and inverted T waves in the presenting ECG of STEMI patients
Author: Koivula, Kimmo; Nikus, Kjell; Viikilä, Juho; Lilleberg, Jyrki; Huhtala, Heini; Birnbaum, Yochai; Eskola, Markku
Contributor: University of Helsinki, HYKS erva
University of Helsinki, Department of Medicine
Date: 2019-01
Language: eng
Number of pages: 9
Belongs to series: Annals of Noninvasive Electrocardiology
ISSN: 1082-720X
URI: http://hdl.handle.net/10138/309289
Abstract: Background Both Q waves and T-wave inversion (TWI) in the presenting ECG are associated with a progressed stage of myocardial infarction, possibly with less potential for myocardial salvage with reperfusion therapy. Combining the diagnostic information from the Q- and T-wave analyses could improve the prognostic work-up in ST-elevation myocardial infarction (STEMI) patients. Methods We sought to determine the prognostic impact of Q waves and TWI in the admission ECG on patient outcome in STEMI. We formed four groups according to the presence of Q waves and/or TWI (Q+TWI+; Q-TWI+; Q+TWI-; Q-TWI-). We studied 627 all-comers with STEMI derived from two patient cohorts. Results The patients with Q+TWI+ had the highest and those with Q-TWI- the lowest 30-day and one-year mortality. One-year mortality was similar between Q-TWI+ and Q+TWI-. The survival analysis showed higher early mortality in Q+TWI- but the higher late mortality in Q-TWI+ compensated for the difference at 1 year. The highest peak troponin level was found in the patients with Q+TWI-. Conclusion Q waves and TWI predict adverse outcome, especially if both ECG features are present. Q waves and TWI predict similar one-year mortality. Extending the ECG analysis in STEMI patients to include both Q waves and TWI improves risk stratification.
Subject: ECG
Q wave
STEMI
T-wave inversion
ACUTE MYOCARDIAL-INFARCTION
ST-SEGMENT ELEVATION
ABNORMAL Q-WAVES
INITIAL Q-WAVES
THROMBOLYTIC THERAPY
ARTERY PATENCY
REPERFUSION
ELECTROCARDIOGRAM
INVERSION
ANTERIOR
3121 General medicine, internal medicine and other clinical medicine
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