Relation of admission QRS duration with development of angiographic no-reflow in patients with acute ST-segment elevation myocardial infarction treated with primary percutaneous interventions.
BACKGROUND
Although QRS-complex changes during ischemia have been described previously, their relation with no-reflow is not clear.


OBJECTIVE
To evaluate relation of admission QRS duration with angiographic no-reflow, we studied 162 patients who underwent primary angioplasty.


METHODS
Twelve-lead electrocardiogram with a paper speed of 50 mm/s was recorded on admission and repeated after angioplasty. Patients were divided into reflow and no-reflow groups based on postangioplasty coronary thrombolysis in myocardial infarction flow grade.


RESULTS
Patients in the no-reflow group (26 patients) were older (P = .001) and had significantly longer pain-to-balloon interval (P = .007). The patients in the no-reflow group had significantly longer QRS duration on admission electrocardiogram compared with patients in the reflow group (interquartile range, 80-93 [median, 84] milliseconds vs 60-80 [median, 76] milliseconds, respectively; P < .001). After adjusting all variables, QRS duration on admission was found to be independently related to angiographic no-reflow (odds ratio, 1.07; 95% confidence interval, 1.02-1.12; P = .003).


CONCLUSIONS
QRS duration on admission may be valuable in predicting no-reflow.
Maden
Orhan
O
Cardiology Department, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey. drorhanmaden@yahoo.co.uk
Kaçmaz
Fehmi
F
Selçuk
Mehmet Timur
MT
Selçuk
Hatice
H
Alyan
Omer
O
Aksu
Tolga
T
Metin
Fatma
F
Tüfekçioğlu
Omaç
O
Atak
Ramazan
R
Demir
Ahmet Duran
AD
Balbay
Yücel
Y
Ilkay
Erdoğan
E
D015906:Angioplasty, Balloon, Coronary / Q000706:statistics & numerical data*; D017023:Coronary Angiography / Q000706:statistics & numerical data; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D004562:Electrocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery*; D010343:Patient Admission / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D014421:Turkey / Q000453:epidemiology