In-hospital prognosis in non-ST-segment elevation acute coronary syndrome derived using a new risk score based on electrocardiographic parameters obtained at admission.
Several electrocardiographic variables are of prognostic value in non-ST-segment elevation acute coronary syndrome (NSTEACS). From observations in 427 patients, we developed a new risk score (the ECG-RS) based on admission ECG findings that can be used to determine the likelihood of death or recurrent ischemia during hospitalization, which occurred in 36% of patients. Logistic regression analysis, which considered seven electrocardiographic variables and variables from the Thrombolysis in Myocardial Infarction (TIMI) risk score, identified the following significant predictors: corrected QT interval (QTc) > or =450 ms (odds ratio 4.2, P< .001), ST-segment depression >0.5 mm (odds ratio 2.7, P< .001), and left atrial enlargement (odds ratio 1.8, P =.005). After taking the odds ratios into consideration, we awarded 3 points for a QTc > or =450 ms, 2 points for ST-segment depression >0.5 mm, and 1 point for left atrial enlargement. When patients were divided into three groups on the basis of their ECG-RSs (i.e. < or =1, 2-3 and > or =4), the risk of death or recurrent ischemia was significantly different between the groups, at 11%, 27% and 58%, respectively (P< .001). In conclusion, the new ECG-RS provides a simple, rapid and accurate means of determining prognosis in patients with NSTEACS.
Jiménez-Candil
Javier
J
Servicio de Cardiología, Hospital Universitario de Salamanca, Salamanca, Spain. jimenezcandil@secardiologia.es
González Matas
José Manuel
JM
Cruz González
Ignacio
I
Hernández Hernández
Jesús
J
Martín
Ana
A
Pabón
Pedro
P
Martín
Francisco
F
Martín-Luengo
Cándido
C
D054058:Acute Coronary Syndrome / Q000175:diagnosis*; D000368:Aged; D004562:Electrocardiography / Q000401:mortality / Q000592:standards*; D005260:Female; D006760:Hospitalization; D006801:Humans; D016015:Logistic Models; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D018570:Risk Assessment