Fragmented QRS and QRS Duration As a Marker of Myocardial Reperfusion Measured by Myocardial Blush Grade in Reperfusion Therapy: Systematic Review and Meta-Analysis

Pranata, Raymond; Yonas, Emir; Chintya, Veresa; Alkatiri, Amir Aziz

doi:10.1055/s-0039-1694790

Cited by 3 publications

(1 citation statement)

References 19 publications

(36 reference statements)

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“…15 an inverse correlation. 16 Incomplete resolution of STsegment depression (reciprocal image of ST elevation) 90 minutes after PCI was correlated with larger infarctions and MACE. 17 The absence of ST resolution was poor prognostic factor after primary PCI, but complete resolution of the ST elevation was associated with an increased risk of ST elevation at the time of discharge.…”

Section: Pharmacoinvasive Therapymentioning

confidence: 99%

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Rangel¹

2021

International Journal of Cardiovascular Sciences

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ST elevation myocardial infarction (STEMI) is a highly prevalent condition worldwide. Reperfusion therapy is strongly associated with the prognosis of STEMI and must be performed with a high standard of quality and without delay. A systematic review of different reperfusion strategies for STEMI was conducted, including randomized controlled trials that included major cardiovascular events (MACE), and systematic reviews in the last 5 years through the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) methodology. The research was done in the PubMed and Cochrane Central Register of Controlled Trials databases, in addition to a few manual searches. After the exclusion criteria were applied, 90 articles were selected for this review. Despite the reestablishment of IRA patency in PCI for STEMI, microvascular lesions occur in a significant proportion of these patients, which can compromise ventricular function and clinical course. Several therapeutic strategies -intracoronary administration of nicorandil, nitrates, melatonin, antioxidant drugs (quercetin, glutathione), antiinflammatory substances (tocilizumab [an inhibitor of interleukin 6], inclacumab, P-selectin inhibitor), immunosuppressants (cyclosporine), erythropoietin and ischemic pre-and post-conditioning and stem cell therapy -have been tested to reduce reperfusion injury, ventricular remodeling and serious cardiovascular events, with heterogeneous results: These therapies need confirmation in larger studies to be implemented in clinical practice PrevalenceThe worldwide prevalence of ischemic heart disease is approximately 111 million cases, with 7.3 million cases of fatal acute myocardial infarction (AMI) in 2015. The inadequate treatment of patients with AMI is associated with significant increases in morbidity and mortality. 1 ObjectivesThe objective of this systematic review is to evaluate the evidence of different reperfusion therapies in STsegment elevation AMI (STEMI), selecting mainly randomized controlled trials and systematic reviews that address major cardiovascular clinical outcomes. MethodsThe review was carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). We searched the PubMed database for the terms "acute myocardial infarction" and "reperfusion therapy", which yielded 9,885 results. After applying the following search filters -type of abstract: "text and full text"; type of article: "metaanalysis, review, systematic review and randomized clinical trial", and date of publication: "last 5 years", and language: "English" -127 articles were obtained. In addition, research was conducted at the Cochrane Central Register of Controlled Trials using the terms "acute myocardial infarction" and "reperfusion therapy", in English, between 2018 and 2020, which revealed 64 clinical trials, already excluding duplicates. Of the 191

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Section: Pharmacoinvasive Therapymentioning

confidence: 99%

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Rangel¹

2021

International Journal of Cardiovascular Sciences

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Heart rate and QRS duration as biomarkers predict the immediate outcome from pulseless electrical activity

Norvik¹,

Kvaløy²,

Skjeflo³

et al. 2023

Resuscitation

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Intraventricular conduction delays as a predictor of mortality in acute coronary syndromes

Lahti

Rankinen

Eskola

et al. 2023

European Heart Journal: Acute Cardiovascular Care

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Abstact Background and aims Initial proof suggests that a non-specific intraventricular conduction delay (NIVCD) is a risk factor for mortality. We explored the prognosis of intraventricular conduction delays (IVCD) – right bundle branch block (RBBB), left bundle branch block (LBBB), and the lesser-known NIVCD – in patients with acute coronary syndrome (ACS). Methods This is a retrospective registry analysis of 9,749 consecutive ACS patients undergoing coronary angiography and with an ECG recording available for analysis (2007–2018). The primary outcome was cardiac mortality. Mortality and cause of death data (in ICD-10 format) were received from the Finnish national register with no losses to follow-up (until December 31, 2020). The risk associated with IVCDs was analyzed by calculating subdistribution hazard estimates (SDH; deaths due to other causes being considered competing events). Results The mean age of the population was 68.3 years (SD 11.8). The median follow-up time was 6.1 years (IQR 3.3–9.4), during which 3,156 patients died. Cardiac mortality was overrepresented among IVCD patients: 76.9% for NIVCD (n = 113/147), 67.6% for LBBB (n = 96/142), 55.7% for RBBB (n = 146/262), and 50.1% for patients with no IVCD (n = 1,275/2,545). In an analysis adjusted for age and cardiac comorbidities, the risk of cardiac mortality was significantly higher in all IVCD groups than among patients with no IVCD: SDH 1.37 (1.15–1.64, p < 0.0001) for RBBB, SDH 1.63 (1.31–2.03 p < 0.0001) for LBBB, and SDH 2.68 (2.19–3.27) for NIVCD. After adjusting the analysis with left ventricular ejection fraction, RBBB and NIVCD remained significant risk factors for cardiac mortality. Conclusion RBBB, LBBB, and NIVCD were associated with higher cardiac mortality in ACS patients.

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Fragmented QRS and QRS Duration As a Marker of Myocardial Reperfusion Measured by Myocardial Blush Grade in Reperfusion Therapy: Systematic Review and Meta-Analysis

Cited by 3 publications

References 19 publications

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Reperfusion Strategies in Acute Myocardial Infarction: State of the Art

Heart rate and QRS duration as biomarkers predict the immediate outcome from pulseless electrical activity

Intraventricular conduction delays as a predictor of mortality in acute coronary syndromes

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