Diagnostic and prognostic value of ST-segment deviation scores in suspected acute myocardial infarction.

Aged Disease Progression Electrocardiography Female Follow-Up Studies Humans Male Middle Aged Prognosis Prospective Studies ROC Curve ST Elevation Myocardial Infarction / diagnosis
Acute coronary syndrome ST-segment deviation electrocardiogram

Journal

European heart journal. Acute cardiovascular care
ISSN: 2048-8734
Titre abrégé: Eur Heart J Acute Cardiovasc Care
Pays: England
ID NLM: 101591369

Informations de publication

Date de publication:
Dec 2020
Historique:
pubmed: 25 1 2020
medline: 1 6 2021
entrez: 25 1 2020
Statut: ppublish

Résumé

Recent advances in digital electrocardiography technology allow evaluating ST-segment deviations in all 12 leads as quantitative variables and calculating summed ST-segment deviation scores. The diagnostic and prognostic utility of summed ST-segment deviation scores is largely unknown. We aimed to explore the diagnostic and prognostic utility of the conventional and the modified ST-segment deviation score (Better Analysis of ST-segment Elevations and Depressions in a 12- Lead-ECG-Score (BASEL-Score): sum of elevations in the augmented voltage right - lead (aVR) plus absolute, unsigned ST-segment depressions in the remaining leads) in patients presenting with suspected non-ST-segment elevation myocardial infarction. The diagnostic endpoint was non-ST-segment elevation myocardial infarction, adjudicated by two independent cardiologists. Prognostic endpoint was mortality during two-year follow up. Among 1330 patients, non-ST-segment elevation myocardial infarction was present in 200 (15%) patients. Diagnostic accuracy for non-ST-segment elevation myocardial infarction as quantified by the area under the receiver-operating-characteristics curve was significantly higher for the BASEL-Score (0.73; 95% confidence interval 0.69-0.77) as compared to the conventional ST-segment deviation score (0.53; 95% confidence interval 0.49-0.57, The modified ST-segment deviation score BASEL-Score focusing on ST-segment elevation in aVR and ST-segment depressions in the remaining leads provides incremental diagnostic and prognostic information.

Sections du résumé

BACKGROUND BACKGROUND
Recent advances in digital electrocardiography technology allow evaluating ST-segment deviations in all 12 leads as quantitative variables and calculating summed ST-segment deviation scores. The diagnostic and prognostic utility of summed ST-segment deviation scores is largely unknown.
METHODS METHODS
We aimed to explore the diagnostic and prognostic utility of the conventional and the modified ST-segment deviation score (Better Analysis of ST-segment Elevations and Depressions in a 12- Lead-ECG-Score (BASEL-Score): sum of elevations in the augmented voltage right - lead (aVR) plus absolute, unsigned ST-segment depressions in the remaining leads) in patients presenting with suspected non-ST-segment elevation myocardial infarction. The diagnostic endpoint was non-ST-segment elevation myocardial infarction, adjudicated by two independent cardiologists. Prognostic endpoint was mortality during two-year follow up.
RESULTS RESULTS
Among 1330 patients, non-ST-segment elevation myocardial infarction was present in 200 (15%) patients. Diagnostic accuracy for non-ST-segment elevation myocardial infarction as quantified by the area under the receiver-operating-characteristics curve was significantly higher for the BASEL-Score (0.73; 95% confidence interval 0.69-0.77) as compared to the conventional ST-segment deviation score (0.53; 95% confidence interval 0.49-0.57,
CONCLUSIONS CONCLUSIONS
The modified ST-segment deviation score BASEL-Score focusing on ST-segment elevation in aVR and ST-segment depressions in the remaining leads provides incremental diagnostic and prognostic information.

Identifiants

DOI: 10.1177/2048872619853579 PMID: 31976746
pubmed: 31976746
doi: 10.1177/2048872619853579
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

857-868

Auteurs

Karin Grimm (K)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Department of Internal Medicine, University Hospital Basel, Switzerland.

Raphael Twerenbold (R)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Roger Abaecherli (R)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Institute for Medical Engineering, Lucerne University of Applied Sciences and Arts, Switzerland.

Jasper Boeddinghaus (J)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Department of Internal Medicine, University Hospital Basel, Switzerland.

Thomas Nestelberger (T)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Luca Koechlin (L)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Valentina Troester (V)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Department of Internal Medicine, University Hospital Basel, Switzerland.

Anna Bourtzou (A)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Dagmar I Keller (DI)

Emergency Department, University Hospital Zurich, Switzerland.

Nicolas Geigy (N)

Emergency Department, Kantonsspital Baselland, Switzerland.

Nikola Kozhuharov (N)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.

Desiree Wussler (D)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Department of Internal Medicine, University Hospital Basel, Switzerland.

Karin Wildi (K)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Petra Hillinger (P)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.

Maria Rubini Giménez (M)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Servicio de Urgencias y Pneumologia, Hospital del Mar - Institut Municipal d'Investigació Mèdica, Spain.
Leipzig Heart Center, Leipzig, Germany.

Ivo Strebel (I)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.

Patrick Badertscher (P)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Christian Puelacher (C)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Department of Internal Medicine, University Hospital Basel, Switzerland.

Jeanne du Fay de Lavallaz (J)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

Luca Osswald (L)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.

Beata Morawiec (B)

2nd Department of Cardiology, Zabrze, Medical University of Silesia in Katowice, Poland.

Damian Kawecki (D)

2nd Department of Cardiology, Zabrze, Medical University of Silesia in Katowice, Poland.

Òscar Miró (Ò)

Emergency Department, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain.

Michael Kühne (M)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.

Tobias Reichlin (T)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.
Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.

Christian Mueller (C)

Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, Switzerland.
Global Research on acute conditions Team (GREAT Network), Italy.

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Sujet âgé › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Évolution de la maladie › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Électrodiagnostic › Électrocardiographie › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études de suivi › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Diagnostic › Pronostic › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études prospectives › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Méthodologie en recherche épidémiologique › Courbe ROC › Diagnostic and prognostic value of ST-segment...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Nécrose › Infarctus › Infarctus du myocarde › Infarctus du myocarde avec sus-décalage du segment ST › Diagnostic and prognostic value of ST-segment...