title: QRS Score at Presentation Electrocardiogram Is Correlated With Infarct Size and Mortality in ST-Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention.
abstract: In ST-segment elevation myocardial infarction (STEMI), QRS score at presentation ECG may reflect the progression of infarction and facilitate prediction of the degree of myocardial salvage achieved by reperfusion therapy.
  
  
  
  Admission electrocardiogram (ECG) was studied in 2,607 patients with STEMI undergoing primary percutaneous coronary intervention (PCI) within 24 h of symptom onset. Patients were classified into 3 groups according to QRS score: low (0-3, n=1,227), intermediate (4-7, n=810), and high (≥8, n=570). An increase of infarct size estimated by median peak creatine phosphokinase was observed as QRS score increased (low score, 1,836 IU/L; inter-quartile range (IQR), 979-3,190 IU/L; intermediate score, 2,488 IU/L; IQR, 1,126-4,640 IU/L; high score, 3,454 IU/L; IQR, 1,759-5,639 IU/L; P<0.001). Higher QRS score was associated with higher long-term mortality (low, intermediate, and high score, 15.6%, 19.7%, and 23.7% at 5 years, respectively; log-rank P<0.001). The positive relationship of QRS score with mortality was consistently seen when stratified by infarct location. The association of high QRS score with increased mortality was most remarkably seen in patients with early (≤2 h) presentation (low, intermediate, and high score: 16.7%, 16.6%, and 28.1% at 5 years, respectively; log-rank P<0.001).
  
  
  
  Higher QRS score at presentation ECG was associated with larger infarct size, and higher long-term mortality in patients with STEMI undergoing primary PCI. QRS score appears to be important in the early risk stratification for STEMI.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Shiomi
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.affiliation: Department of Clinical Epidemiology, Hyogo College of Medicine.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Morimoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Taniguchi
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Kenji
authors.initials: K
authors.lastname: Nakatsuma
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Toyota
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Erika
authors.initials: E
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shizuta
authors.affiliation: Division of Cardiology, Shizuoka General Hospital.
authors.forename: Tomohisa
authors.initials: T
authors.lastname: Tada
authors.affiliation: Division of Cardiology, Kobe City Medical Center General Hospital.
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Furukawa
authors.affiliation: Division of Cardiology, Tenri Hospital.
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Nakagawa
authors.affiliation: Division of Cardiology, Kokura Memorial Hospital.
authors.forename: Kenji
authors.initials: K
authors.lastname: Ando
authors.affiliation: Division of Cardiology, Kurashiki Central Hospital.
authors.forename: Kazushige
authors.initials: K
authors.lastname: Kadota
authors.affiliation: Division of Cardiology, Yokohama City University Medical Center.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention; D000072657:ST Elevation Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000503:physiopathology / Q000601:surgery
keywords: Acute myocardial infarction; Electrocardiography; Primary percutaneous coronary intervention