Elmas Ali Nizami, Fedai Halil, Toprak Kenan, Taşcanov Mustafa Begenç, Altıparmak İbrahim Halil, Biçer Asuman, Demirbağ Recep, Tanrıverdi Zülkif
Clinic of Cardiology, Menderes State Hospital, İzmir, Türkiye.
Department of Cardiology, Faculty of Medicine, Harran University, Şanlıurfa, Türkiye.
Anatol J Cardiol. 2024 Nov 25;29(1):11-8. doi: 10.14744/AnatolJCardiol.2024.4726.
Acute coronary syndromes are the leading cause of mortality worldwide. Electrical risk score (ERS) is a novel electrocardiographic risk scoring system. The prognostic importance of ERS in non-ST elevation myocardial infarction (NSTEMI) patients is unknown. We aimed to determine the association of ERS with in-hospital prognosis in NSTEMI patients undergoing coronary angiography (CAG).
A total of 427 consecutive NSTEMI patients undergoing CAG were enrolled in this study. Six parameters comprised ERS: pulse rate >75, left ventricular hypertrophy according to Sokolow-Lyon criteria, QRS transition zone ≥V4, corrected QT (QTc) interval >450 for men and >460 for women, T peak to T end interval (Tp-e) >89 ms, and frontal QRS-T angle >90°. The ERS was calculated according to the number of abnormal findings in electrocardiogram. The study population was divided into 2 groups as ERS <3 and ≥3.
No significant difference was found between ERS ≥3 and <3 groups in terms of demographic characteristics. However, patients with ERS ≥3 had significantly higher maximum troponin (P < .001), thrombolysis in myocardial infarction (P = .002), and global registry of acute coronary events (P < .001) risk scores and 3-vessel disease frequency (P = .001), whereas they had lower left ventricular ejection fraction (P < .001). These patients also had higher frequency of in-hospital mortality (P < .001) and adverse events. Multiple logistic regression analysis demonstrated that ERS (OR = 1.790, 95% CI: 1.036-3.095, P = .037) was an independent predictor of in-hospital mortality.
The frequency of in-hospital adverse events and mortality was significantly higher in NSTEMI patients with an ERS ≥3 at admission. This simple electrocardiographic risk marker may help identify patients at higher cardiac risk in patients presenting with NSTEMI and identify patients who may need early coronary intervention.
急性冠状动脉综合征是全球范围内主要的死亡原因。电风险评分（ERS）是一种新型的心电图风险评分系统。ERS在非ST段抬高型心肌梗死（NSTEMI）患者中的预后重要性尚不清楚。我们旨在确定ERS与接受冠状动脉造影（CAG）的NSTEMI患者院内预后之间的关联。
本研究共纳入427例连续接受CAG的NSTEMI患者。ERS由六个参数组成：脉搏率>75、根据索科洛夫-里昂标准诊断的左心室肥厚、QRS过渡区≥V4、男性校正QT（QTc）间期>450，女性>460、T峰至T末间期（Tp-e）>89 ms以及额面QRS-T角>90°。根据心电图异常表现的数量计算ERS。研究人群分为ERS<3和≥3两组。
ERS≥3组和<3组在人口统计学特征方面无显著差异。然而，ERS≥3的患者肌钙蛋白峰值显著更高（P<.001）、心肌梗死溶栓（P=.002）和急性冠状动脉事件全球注册（P<.001）风险评分以及三支血管病变频率显著更高（P=.001），而左心室射血分数更低（P<.001）。这些患者院内死亡率（P<.001）和不良事件的发生率也更高。多因素逻辑回归分析表明，ERS（OR=1.790，95%CI：1.036-3.095，P=.
