Clinical Impact of Q-Wave Presence on Electrocardiogram at Presentation of Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention

Title
Clinical Impact of Q-Wave Presence on Electrocardiogram at Presentation of Patients With ST-segment Elevation Myocardial Infarction Undergoing Primary Coronary Intervention
Author(s)
박종선김웅손장원김영조
Keywords
MAGNETIC-RESONANCE; ANGIOPLASTY; MORTALITY; PATTERNS; THERAPY; TIME
Issue Date
201409
Publisher
INT HEART JOURNAL ASSOC
Citation
INTERNATIONAL HEART JOURNAL, v.55, no.5, pp.404 - 408
Abstract
This study evaluated the clinical impact of Q-wave presence on ECG at presentation of patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). From April 2005 to September 2009, 184 consecutive STEMI patients who underwent primary PCI within 12 hours of chest pain onset were retrospectively evaluated. Patients were grouped according to the presence (Q positive, n = 109) or absence (Q negative, n= 75) of Q waves on initial ECG at emergency room presentation. Major adverse cardiac events (MACE) and stent thrombosis (ST) were evaluated for 2 years. Risk factors for MACE and left ventricular (LV) remodeling by echocardiography were also evaluated. Baseline characteristics, including reperfusion time and infarct location, were similar between the groups. The MACE rate at 2 years was higher in the Q-positive group (32.1%) than in the Q-negative group (13.3%, P = 0.005). Independent risk factors for MACE were the presence of Q-wave (P = 0.008, Odds ratio 3.139) and no-reflow phenomenon (P = 0.016, Odds ratio, 2.819). LV remodeling was more frequent in the Q-positive group (47.9%) than in the Q-negative (24.5%, P = 0.009) group. Initial Q-wave presence (P = 0.048, Odds ratio 2.380) and anterior wall MI (P = 0.009, Odds ratio, 3.425) were independent risk factors for LV remodeling. The presence of Q waves in ECG of patients presenting with STEMI undergoing primary PCI provides an independent prognostic marker of clinical outcomes and left ventricular remodeling.
URI
http://hdl.handle.net/YU.REPOSITORY/30895
ISSN
1349-2365
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의과대학 > 내과학교실 > Articles
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