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Article

In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention

1
Department of Internal Medicine and Cardiology, University Hospital Brno, Jihlavska 20, 625 00 Brno, Czech Republic
2
Department of Internal Medicine and Cardiology, Faculty of Medicine, Masaryk University, Jihlavska 20, 625 00 Brno, Czech Republic
3
National Heart and Lung Institute, Imperial College of London, 72 Du Cane Rd, Shepherd’s Bush, London W12 0NN, UK
*
Author to whom correspondence should be addressed.
Academic Editor: Michael Henein
Diagnostics 2021, 11(5), 799; https://doi.org/10.3390/diagnostics11050799
Received: 21 March 2021 / Revised: 14 April 2021 / Accepted: 26 April 2021 / Published: 28 April 2021
(This article belongs to the Section Pathology and Molecular Diagnostics)
The development of pathological Q waves has long been correlated with worsened outcome in patients with ST elevation myocardial infarction (STEMI). In this study, we investigated long-term mortality of STEMI patients treated by primary percutaneous coronary intervention (PPCI) and compared predictive values of Q waves and of Selvester score for infarct volume estimation. Data of 283 consecutive STEMI patients (103 females) treated by PPCI were analysed. The presence of pathological Q wave was evaluated in pre-discharge electrocardiograms (ECGs) recorded ≥72 h after the chest pain onset (72 h Q). The Selvester score was evaluated in acute ECGs (acute Selvester score) and in the pre-discharge ECGs (72 h Selvester score). The results were related to total mortality and to clinical and laboratory variables. A 72 h Q presence and 72 h Selvester score ≥6 was observed in 184 (65.02%) and 143 (50.53%) patients, respectively. During a follow-up of 5.69 ± 0.66 years, 36 (12.7%) patients died. Multivariably, 72 h Selvester score ≥6 was a strong independent predictor of death, while a predictive value of the 72 h Q wave was absent. In high-risk subpopulations defined by clinical and laboratory variables, the differences in total mortality were highly significant (p < 0.01 for all subgroups) when stratified by 72 h Selvester score ≥6. On the contrary, the additional risk-prediction by 72 h Q presence was either absent or only borderline. In contemporarily treated STEMI patients, Selvester score is a strong independent predictor of long-term all-cause mortality. On the contrary, the prognostic value of Q-wave presence appears limited in contemporarily treated STEMI patients. View Full-Text
Keywords: primary percutaneous coronary intervention; Q wave; Selvester score; ST elevation myocardial infarction primary percutaneous coronary intervention; Q wave; Selvester score; ST elevation myocardial infarction
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MDPI and ACS Style

Holicka, M.; Cuckova, P.; Hnatkova, K.; Koc, L.; Ondrus, T.; Lokaj, P.; Parenica, J.; Novotny, T.; Kala, P.; Malik, M. In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention. Diagnostics 2021, 11, 799. https://doi.org/10.3390/diagnostics11050799

AMA Style

Holicka M, Cuckova P, Hnatkova K, Koc L, Ondrus T, Lokaj P, Parenica J, Novotny T, Kala P, Malik M. In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention. Diagnostics. 2021; 11(5):799. https://doi.org/10.3390/diagnostics11050799

Chicago/Turabian Style

Holicka, Maria, Pavla Cuckova, Katerina Hnatkova, Lumir Koc, Tomas Ondrus, Petr Lokaj, Jiri Parenica, Tomas Novotny, Petr Kala, and Marek Malik. 2021. "In Comparison to Pathological Q Waves, Selvester Score Is a Superior Diagnostic Indicator of Increased Long-Term Mortality Risk in ST Elevation Myocardial Infarction Patients Treated with Primary Coronary Intervention" Diagnostics 11, no. 5: 799. https://doi.org/10.3390/diagnostics11050799

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