因直接经皮冠状动脉介入治疗（PCI）而被转诊至紧急医疗系统的ST段抬高型心肌梗死（STEMI）患者的预后及首次诊断性心电图
Prognosis and first diagnostic ECG in STEMI patients referred to the emergency medical system for primary PCI.
作者信息
Meloni Luigi, Marchetti Maria Francesca, Cacace Cristina, Congia Michela, Scotto Roberta, Caddeo Piero, Montisci Roberta
机构信息
Clinical Cardiology, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
Clinical Cardiology, Department of Medical Sciences and Public Health, University of Cagliari, Italy.
出版信息
J Electrocardiol. 2018 Nov-Dec;51(6):1131-1134. doi: 10.1016/j.jelectrocard.2018.09.003. Epub 2018 Sep 12.
BACKGROUND
Pathological Q waves (QWs) in the first ECG recorded at hospital admission has been found to correlate with myocardial damage and mortality in STEMI patients. We investigated the association between new QWs recorded in the pre-hospital setting and adverse outcome during the hospital stay.
METHODS
A pre-hospital ECG was recorded in 248 patients with STEMI who underwent primary PCI. Patients were divided into two groups based on the presence (n = 44, QWs) or absence (n = 204, non-QWs) of new QWs.
RESULTS
Patients with new QWs had a higher prevalence of anterior infarct, cardiogenic shock and a lower LV ejection fraction. In-hospital mortality was higher in patients with new QWs. The percentage of patients with new QWs increased progressively with increasing pain to ECG time.
CONCLUSIONS
New QWs provide rapid prognostic information in the pre-hospital phase of STEMI by identifying patients at risk of adverse outcome during the hospital stay.
背景
入院时首次心电图记录中的病理性Q波（QWs）已被发现与ST段抬高型心肌梗死（STEMI）患者的心肌损伤和死亡率相关。我们研究了院前记录的新QWs与住院期间不良结局之间的关联。
方法
对248例行直接经皮冠状动脉介入治疗（PCI）的STEMI患者进行了院前心电图记录。根据是否存在新QWs（存在新QWs的患者44例，QWs组；不存在新QWs的患者204例，非QWs组）将患者分为两组。
结果
有新QWs的患者前壁梗死、心源性休克的发生率较高，左心室射血分数较低。有新QWs的患者院内死亡率较高。新QWs患者的比例随着疼痛至心电图时间的增加而逐渐增加。
结论
新QWs通过识别住院期间有不良结局风险的患者，在STEMI的院前阶段提供快速的预后信息。
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