Distortion of the QRS in elderly patients with myocardial infarction
Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age. We analysed 634 consecutive patients (a...
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Published in | Cardiology journal Vol. 16; no. 5; pp. 418 - 425 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Poland
2009
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Abstract | Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age.
We analysed 634 consecutive patients (age 62.6 +/- 13.7, 77% male) admitted in the first 12 hours of ST-elevation myocardial infarction. Two groups of age were defined: < 75 years-old and >or= 75 years-old. Additionally, we defined two ECG groups according to the presence of ST segment elevation with distortion of the terminal portion of the QRS in two or more adjacent leads (QRS+) or the absence of this pattern (QRS-). Older people had more often QRS+ (30% vs. 20%, p = 0.023). The older group with QRS+ had an in-hospital mortality of 18%, vs. 7% with QRS- (p = 0.04), and an incidence of major adverse events of 40% vs. 14% (p = 0.002). In the multivariate analysis, age >or= 75 years was an independent predictor of distortion of the QRS (odds ratio 2.1, 1.2-4.9, p = 0.016).
The distortion of the terminal portion of the QRS in myocardial infarction is more frequent in elderly people, and is significantly related to adverse prognosis. This ECG finding can be helpful to promptly stratify the risk in elderly patients. |
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AbstractList | Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age.
We analysed 634 consecutive patients (age 62.6 +/- 13.7, 77% male) admitted in the first 12 hours of ST-elevation myocardial infarction. Two groups of age were defined: < 75 years-old and >or= 75 years-old. Additionally, we defined two ECG groups according to the presence of ST segment elevation with distortion of the terminal portion of the QRS in two or more adjacent leads (QRS+) or the absence of this pattern (QRS-). Older people had more often QRS+ (30% vs. 20%, p = 0.023). The older group with QRS+ had an in-hospital mortality of 18%, vs. 7% with QRS- (p = 0.04), and an incidence of major adverse events of 40% vs. 14% (p = 0.002). In the multivariate analysis, age >or= 75 years was an independent predictor of distortion of the QRS (odds ratio 2.1, 1.2-4.9, p = 0.016).
The distortion of the terminal portion of the QRS in myocardial infarction is more frequent in elderly people, and is significantly related to adverse prognosis. This ECG finding can be helpful to promptly stratify the risk in elderly patients. BACKGROUNDDistortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age.METHODS AND RESULTSWe analysed 634 consecutive patients (age 62.6 +/- 13.7, 77% male) admitted in the first 12 hours of ST-elevation myocardial infarction. Two groups of age were defined: < 75 years-old and >or= 75 years-old. Additionally, we defined two ECG groups according to the presence of ST segment elevation with distortion of the terminal portion of the QRS in two or more adjacent leads (QRS+) or the absence of this pattern (QRS-). Older people had more often QRS+ (30% vs. 20%, p = 0.023). The older group with QRS+ had an in-hospital mortality of 18%, vs. 7% with QRS- (p = 0.04), and an incidence of major adverse events of 40% vs. 14% (p = 0.002). In the multivariate analysis, age >or= 75 years was an independent predictor of distortion of the QRS (odds ratio 2.1, 1.2-4.9, p = 0.016).CONCLUSIONSThe distortion of the terminal portion of the QRS in myocardial infarction is more frequent in elderly people, and is significantly related to adverse prognosis. This ECG finding can be helpful to promptly stratify the risk in elderly patients. |
Author | Manzano, María C García-Borbolla, Rafael de Isla, Leopoldo Pérez Lennie, Vera García-Rubira, Juan C Cobos, Miguel A Fernández-Ortiz, Antonio Macaya, Carlos Núnez-Gil, Iván |
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Snippet | Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our... BACKGROUNDDistortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial... |
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SubjectTerms | Age Factors Aged Angioplasty, Balloon, Coronary Arrhythmias, Cardiac - etiology Arrhythmias, Cardiac - mortality Arrhythmias, Cardiac - physiopathology Electrocardiography Female Heart Conduction System - physiopathology Hospital Mortality Humans Logistic Models Male Middle Aged Myocardial Infarction - complications Myocardial Infarction - mortality Myocardial Infarction - physiopathology Myocardial Infarction - therapy Odds Ratio Predictive Value of Tests Risk Assessment Risk Factors Shock, Cardiogenic - etiology Shock, Cardiogenic - mortality Shock, Cardiogenic - physiopathology Thrombolytic Therapy Time Factors Treatment Outcome |
Title | Distortion of the QRS in elderly patients with myocardial infarction |
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