Variations of electrocardiographic parameters during hospitalization predict long‐term outcomes in patients with non‐ST‐segment elevation myocardial infarction

• Published in: Annals of noninvasive electrocardiology Vol. 24; no. 2; pp. e12613 - n/a
• Main Authors: Li, Guoyong, Li, Qiao, Huang, Baotao, Chen, Mao
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.03.2019; John Wiley and Sons Inc
• Subjects: Acute Coronary Syndrome - diagnostic imaging; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - physiopathology; Acute coronary syndromes; Aged; Cause of Death; China; Cohort Studies; Diabetes mellitus; EKG; Electrocardiography; Electrocardiography - methods; Female; Follow-Up Studies; Heart attacks; Hospital Mortality; Hospitalization - statistics & numerical data; Hospitals, University; Humans; Hypertension; Lesions; Male; Middle Aged; Myocardial infarction; Non-ST Elevated Myocardial Infarction - diagnostic imaging; Non-ST Elevated Myocardial Infarction - mortality; Non-ST Elevated Myocardial Infarction - physiopathology; Original; P waves; Parameters; Patient Admission; Patient Discharge; Patients; Predictive Value of Tests; Regression analysis; Retrospective Studies; Risk analysis; Risk Assessment; Risk factors; Severity of Illness Index; Survival Rate; Time Factors; China
• ISSN: 1082-720X; 1542-474X; 1542-474X
• DOI: 10.1111/anec.12613

Background Electrocardiogram is an essential modality for diagnosis and early risk stratification for patients with acute coronary syndrome (ACS), but its long‐term prognostic value has not been well studied. This study tried to investigate the long‐term prognostic value of variations of ECG parameters at admission and discharge in patients with non‐ST‐segment elevation myocardial infarction (NSTEMI). Methods A total of 170 NSTEMI patients were recruited consecutively from 2013 to 2014 in West China Hospital of Sichuan University. All subjects' ECGs at admission and discharge were reviewed. Follow‐up was performed, and the survival difference between groups was analyzed. Results Comparing with at admission, NSTEMI patients at discharge with a wider P wave (19.4% vs. 8.1%, p = 0.047), with new‐onset PtfV1 positive (31.2% vs. 8.1%, 11.5%, 13.3%, p = 0.147) and with a greater number of leads showing ST depression (21.9% vs. 10.3%, p = 0.037) were prone to MACEs during long‐term follow‐up. The independent risk factors for the primary endpoints determined using a multivariate cox regression were new‐onset PtfV1 positive during hospitalization (HR = 4.705, 95% CI = 1.457–15.197, p = 0.010) and prolonged QRS duration at discharge comparing to admission (HR = 2.536, 95% CI = 1.057–6.083, p = 0.030), besides diabetes mellitus, stage 3 hypertension, and multiple vessel lesions. Conclusion Discharge ECG with new‐onset PtfV1 positive and prolonged QRS duration were independent risk factors for recurrence of MACEs in NTEMI patients. The differences of ECG parameters between at admission and discharge, including P‐wave duration, number of leads with ST‐segment depression, carried long‐term prognostic information for NSTEMI patients.