ISSN 1016-5169 | E-ISSN 1308-4488
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Relationship of frontal QRS-T angle with coronary flow grade and advers events before percutaneous coronary intervention in patients with non-ST elevation myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-65627 | DOI: 10.5543/tkda.2022.65627

Relationship of frontal QRS-T angle with coronary flow grade and advers events before percutaneous coronary intervention in patients with non-ST elevation myocardial infarction

Uğur Küçük1, Kadir Arslan1, Uğur Özpınar1, Burak Altun2
1Department of Cardiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, Türkiye
2Department of Cardiology, İstanbul Cerrahi Hospital, İstanbul, Türkiye


OBJECTIVE
Electrocardiography (ECG) is used in the initial risk assessment of patients with non-ST-elevation myocardial infarction (NSTEMI). The frontal QRS-T [F(QRS-T)] angle is an ECG parameter that may be affected by the alterations in the coronary blood flow. The aim of this study was to explore the relationship of the F(QRS-T) angle with coronary flow grade and adverse events in NSTEMI patients.


METHODS
A total of 191 NSTEMI patients were divided into two groups based on the thrombolysis in myocardial infarction (TIMI) flow level on coronary angiography (CAG) before revascularization, namely TIMI 0/1 and TIMI 2/3. The F(QRS-T) angle obtained before revascularization was compared between the groups and its relationship with adverse events was examined. In-hospital all-cause mortality, repeat target lesion revascularization, new onset heart failure, ventricular arrhythmias and atrial fibrillation were defined as adverse events.


RESULTS
F(QRS-T) angle was wider in the patients with TIMI 0/1 flow compated to the patients with TIMI 2/3 flow (P <0.001). The F(QRS-T) angle was determined to be a predictor of TIMI flow grade 0/1 before revascularization in patients with NSTEMI (odds ratio [OR]: 1.51; 95% confidence interval [CI]: 1.30–1.75; P<0.001). The F(QRS-T) angle was a predictor of the adverse events during hospitalization in the patients with NSTEMI (OR: 1.11; 95% CI: 1.04–1.19; P=0.002). The cutoff values of the frontal QRS-T angle for TIMI flow grade and adverse events were determined to be 73.5°, based on receiver operating characteristic curve analysis.


CONCLUSION
Increased F(QRS-T) angle may be a useful ECG parameter for determining TIMI flow grade and the need for an early invasive strategy in patients with NSTEMI.

Keywords: Electrocardiography, Frontal QRS-T angle, NSTEMI, percutaneous coronary intervention

How to cite this article


Corresponding Author: Uğur Küçük, Türkiye
Manuscript Language: English


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