Predictive value of QRS score for severity of coronary artery disease in ST-segment elevation myocardial infarction

Background: The Selvester QRS scoring system is used to measure infarct size before current use of thrombolytic therapy. The relationship between QRS score and left ventricular ejection fraction has also been described. Several studies showed the associations of QRS score with coronary angiographic severity in acute ST Elevation Myocardial Infarction. General objectives: To find out the Predictive value of QRS score for severity of coronary artery disease in ST-segment elevation myocardial infarction Methodology: This cross-sectional study was conducted in the Department of Cardiology, Sylhet MAG Osmani Medical College Hospital, Sylhet, during the period from January 2014 to December 2015. A total of fifty patients with ST Elevation Myocardial Infarction based on predefined enrolment criteria were included. QRS score was calculated for all patients at the time admission from admission ECG. Coronary angiography was performed using standard techniques. Severity of CAD was determined by vessels score and Friesinger score. Results: The mean age of the patients was 49.14 (SD 11.50) years. Majority of the patients were male 44 (88%) with a ratio of male to female was 7.33:1. Among the cardiovascular risk factors, QRS score showed significant difference (p=0.028) between smoker and non-smoker group but in other risk factors group there was no significant difference. There was no significant difference in QRS score between two groups of patients who had DM, hypertension, dyslipidaemia and Family History of CAD who didn’t have DM, hypertension, dyslipidaemia and Family History of CAD (p>0.05). Conclusion: It is concluded that high admission QRS score is associated with more severe coronary artery involvement in patients with acute ST elevation MI. Higher admission score of QRS in acute ST elevation myocardial infarction may be considered as a simple diagnostic tool for assessing angiographic severity of coronary artery disease. However, multicentric trial is needed to assess the reliability and validity of QRS score in acute ST elevation myocardial infarction to predict severity of coronary artery disease.