R/S ratio in lead II, and the prognostic significance of red cell distribution width in acute coronary syndrome

Abstract

BACKGROUND In spite of developing medical technologies to discover the etiopathogenesis of diseases and developments in the treatment of coronary artery disease, acute coronary syndromes (ACS) continue to be the main cause of mortality and morbidity worldwide. New cardiac biomarkers and techniques are needed to help provide rapid diagnosis in order to evaluate risk in coronary artery patients. AIM To evaluate the effects of R to S ratio (RSR) in the electrocardiograph of patients with ACS, from the point of the arising complication after myocardial infarction (MI), to three-vessel disease (TVD) and mortality. METHODS The data of 1,296 patients with ACS, who presented to the emergency department of our hospital with chest pain between January 2014 and December 2018 and were admitted to the cardiology clinic, were retrospectively included in this cross-sectional cohort study. Patients with an RSR value less than I were assigned to group I, while those with an RSR value greater than I were assigned to group II. RESULTS In our study, 466 (35.9%) of the 1,296 patients, 357 (38.3%) in group 1 and 109 (29.9%) in group 2, were female, with a mean age of 61.56 ± 9.42. ST-elevation MI 573 (44.2%), unstable angina (UA) 502 (38.7%) and non ST-elevation MI 220 (17%) were more prevalent in group I. Acute anterior MI 263 (20.3) in group I, and acute inferior MI 184 (14.2) in group II was higher. Ischemic heart failure was the most common complication. In group II, the red cell distribution width (RDW) was 15.42 ± 1.82, the gensini score was 48.39 ± 36.44, the left ventricular ejection fraction was 41.17 ± 10.41, the TVD was 111 (8.5), and the mortality rate was 72 (5.6), which was significantly higher than group I RDW; in MI with ST and non-ST-elevation, in TVD, mortality and complications were high and low in UA. In single and multivariate regression analyses, the variables were associated with ACS risk. CONCLUSION RSR levels may be an auxiliary predictive value in ACS in terms of complications developing after MI, TVD, and mortality.

System of integrating biosignals during hemodialysis: the CONTINUAL (Continuous mOnitoriNg viTal sIgN dUring hemodiALysis) registry

“…On initiation of hemodialysis, sinus tachycardia was noted, and the systolic and diastolic BPs were 156 mmHg and 120 mmHg, respectively. Forty-six minutes after starting hemodialysis, the ratio of R to S on ECG was ≥1 [ 20 ], followed by depression of the ST segment and high amplitude of the R wave ( Fig. 3 ).…”

Is Red Cell Distribution Width a Reliable Marker for Cardiovascular Diseases? A Narrative Review

“…The latter is associated with worse cardiovascular outcomes in patients with MI. 89 In another study on diabetic patients, it was indicated that patients with RDW higher than 16.1% are at higher risk for MI, stroke, and cardiovascular death. They also postulated that higher RDW is associated with all-cause mortality.…”

Tikagrelor Yüklemesi Yapılan Akut Koroner Sendrom Hastalarında Fragmante QRS Kompleksinin Bir Yıllık Mortalitedeki Prediktif Değeri

“…Hastaların prognozunu belirlemek için EKG parametreleri ile ilgili çeşitli çalışmalar yapılmıştır. Selvester QRS skoru, R/S oranı ve fragmante QRS kompleksi (fQRS) EKG'de değerlendirilen parametrelerdendir (10)(11)(12).…”