Güney Erdoğan1, Mustafa Yenerçağ2, Diyar Köprülü3, Özgün Çakmak4, Uğur Arslan1, Ali Karagöz4, Elnur Alizade4

1University Of Health Sciences Turkey, Samsun Training And Research Hospital, Cardiology Clinic, Samsun, Turkey
2Ordu University, Training And Research Hospital, Cardiology Clinic, Ordu, Turkey
3Ordu State Hospital, Cardiology Clinic, Ordu, Turkey
4University Of Health Sciences Turkey Kartal Kosuyolu Research And Training Hospital, Cardiology Clinic, Istanbul, Turkey

Keywords: frontal qrs-t angle, thrombus burden, st elevated myocardial infarction

Abstract

Objectives: Despite the relevance of the frontal QRS-T angle to the distribution, grade, and complexity of coronary artery disease in ST-elevated myocardial infarction(STEMI) , until now no studies have particularly addressed the association of frontal QRST angle with thrombus burden in STEMI. The goal of this study was to assess whether a relevance exists between the frontal QRST angle and the thrombus burden in STEMI.

Patients and Methods: In this retrospective cross-sectional analysis, 192 STEMI patients who underwent primary percutaneous coronary intervention were separated according to TIMI thrombus grade; those with a high thrombus burden(46 patients) and those with a low thrombus burden(146 patients) included. Thrombus burden was categorized according to thrombolysis in myocardial infarction (TIMI) thrombus grades. Frontal QRST angle calculation was done as the absolute value of the difference of the QRS and T axes.

Results: In multivariable analysis, frontal QRST angle (OR: 1.270, 95% CI: 1.140-1.410, p=0.001), CRP (OR: 1.185, 95% CI: 1.015-1.383, p=0.032), and troponin I (OR: 1.295, 95% CI: 1.091-1.536, p=0.003) were independently associated with high thrombus burden. In ROC analysis, the value of 76.5 for frontal QRS-T angle had a 76% sensitivity and a 74% specificity (area under curve (AUC): 0.76, p<0.001) for the estimation of high thrombus burden in STEMI.

Conclusion: Frontal QRST angle is a useful tool to detect high thrombus burden in STEMI.