Combined use of frontal plane QRS‐T angle and platelet‐to‐lymphocyte ratio in the risk prediction of ischemic cardiomyopathy in STEMI

• Published in: Annals of noninvasive electrocardiology Vol. 29; no. 1; pp. e13106 - n/a
• Main Authors: Colluoglu, Tugce, Aksu, Melahat Hicran, Akın, Yesim, Onalan, Orhan
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.01.2024; John Wiley and Sons Inc; Wiley
• Subjects: Biomarkers; Blood platelets; Cardiology; Cardiomyocytes; Cardiomyopathies; Cardiomyopathy; Creatinine; Echocardiography; Electrocardiography; frontal plane QRS‐T angle; Heart; Heart attacks; Heart failure; Humans; Hyperlipidemia; Ischemia; ischemic cardiomyopathy; Lymphocytes; Myocardial infarction; Normal distribution; Original; Platelets; platelet‐to‐lymphocyte ratio; Regression analysis; Risk assessment; risk stratification; ST Elevation Myocardial Infarction - diagnostic imaging; ST Elevation Myocardial Infarction - surgery; Stroke Volume; Ventricle; Ventricular Function, Left; platelet-to-lymphocyte ratio; ischemic cardiomyopathy; risk stratification; frontal plane QRS-T angle
• ISSN: 1082-720X; 1542-474X; 1542-474X
• DOI: 10.1111/anec.13106

Background Frontal plane QRS‐T angle (fQRS‐T) and platelet‐to‐lymphocyte ratio (PLR) are highly important parameters that well‐predict unfavorable outcomes in patients with ST‐elevated myocardial infarction (STEMI).There are limited data on the predictive significance of ischemic cardiomyopathy (I‐CMP) from the combination of fQRS‐T and PLR in STEMI, compared to using fQRS‐T and PLR alone. Aim We aimed to evaluate the ability of the combination of fQRS‐T and PLR routinely obtained on admission to identify STEMI patients at risk of I‐CMP. Method Six hundred and thirty‐eight consecutive patients with STEMI who underwent primary percutaneous coronary intervention between 2018 and 2021 were included. The assessment of I‐CMP was conducted through two‐dimentional (2D)‐echocardiography 6 weeks post‐STEMI and I‐CMP was defined as a left ventricular ejection fraction (LVEF) of 50% or less. Multivariate logistic regression analysis and receiver operating curve (ROC) analysis were performed to predict the development of I‐CMP. Results In ROC analysis, the cut‐off values of fQRS‐T and PLR for best predicting I‐CMP were 66.72° and 101.23, respectively. The model using the combination of two markers was the most powerful predictor of I‐CMP risk (OR: 3.183, 95% CI: 1.971–5.139, p = .001) when included in a single variable such as high fQRS‐T or high PLR (OR: 1.422, 95% CI: 0.870–0.232, p = .160). Additionally, the concomitant presence of high fQRS‐T and high PLR exhibited the highest specificity (77%) for I‐CMP relative to the individual presence of high fQRS‐T (66%) or PLR (49%). Conclusion The combination of fQRS‐T and PLR, which is a simple and cost‐effective risk assessment, may serve as a more reliable prognosticator for I‐CMP as opposed to the use of fQRS‐T and PLR alone for STEMI. The concurrent presence of a high frontal plane QRS‐T angle (fQRS‐T) and a high platelet‐to‐lymphocyte ratio (PLR) poses the highest risk for the development of ischemic cardiomyopathy 6 weeks after ST‐elevation myocardial infarction, in comparison to solely high fQRS‐T or high PLR alone.