Combined use of frontal plane QRS-T angle and platelet-to-lymphocyte ratio in the risk prediction of ischemic cardiomyopathy in STEMI

ÇÖLLÜOĞLU İ. T., Aksu M. H., Akin Y., ÖNALAN O.

ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, cilt.29, sa.1, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 29 Sayı: 1
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1111/anec.13106
  • Dergi Adı: ANNALS OF NONINVASIVE ELECTROCARDIOLOGY
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Anahtar Kelimeler: frontal plane QRS-T angle, ischemic cardiomyopathy, platelet-to-lymphocyte ratio, risk stratification
  • Dokuz Eylül Üniversitesi Adresli: Hayır

Özet

BackgroundFrontal plane QRS-T angle (fQRS-T) and platelet-to-lymphocyte ratio (PLR) are highly important parameters that well-predict unfavorable outcomes in patients with ST-elevated myocardial infarction (STEMI).There are limited data on the predictive significance of ischemic cardiomyopathy (I-CMP) from the combination of fQRS-T and PLR in STEMI, compared to using fQRS-T and PLR alone.AimWe aimed to evaluate the ability of the combination of fQRS-T and PLR routinely obtained on admission to identify STEMI patients at risk of I-CMP.MethodSix hundred and thirty-eight consecutive patients with STEMI who underwent primary percutaneous coronary intervention between 2018 and 2021 were included. The assessment of I-CMP was conducted through two-dimentional (2D)-echocardiography 6 weeks post-STEMI and I-CMP was defined as a left ventricular ejection fraction (LVEF) of 50% or less. Multivariate logistic regression analysis and receiver operating curve (ROC) analysis were performed to predict the development of I-CMP.ResultsIn ROC analysis, the cut-off values of fQRS-T and PLR for best predicting I-CMP were 66.72 degrees and 101.23, respectively. The model using the combination of two markers was the most powerful predictor of I-CMP risk (OR: 3.183, 95% CI: 1.971-5.139, p = .001) when included in a single variable such as high fQRS-T or high PLR (OR: 1.422, 95% CI: 0.870-0.232, p = .160). Additionally, the concomitant presence of high fQRS-T and high PLR exhibited the highest specificity (77%) for I-CMP relative to the individual presence of high fQRS-T (66%) or PLR (49%).ConclusionThe combination of fQRS-T and PLR, which is a simple and cost-effective risk assessment, may serve as a more reliable prognosticator for I-CMP as opposed to the use of fQRS-T and PLR alone for STEMI. The concurrent presence of a high frontal plane QRS-T angle (fQRS-T) and a high platelet-to-lymphocyte ratio (PLR) poses the highest risk for the development of ischemic cardiomyopathy 6 weeks after ST-elevation myocardial infarction, in comparison to solely high fQRS-T or high PLR alone.image