Document Detail

The modified Selvester QRS score: can we predict successful ST segment resolution in patients with myocardial infarction receiving fibrinolytic therapy?
MedLine Citation:
PMID:  20690092     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: We sought to explore whether the simplified Selvester QRS scoring system could predict ST segment resolution in patients with first acute ST segment elevation myocardial infarction who receive pharmacological reperfusion therapy.
METHODS: We enrolled 60 consecutive patients admitted to the critical care unit with the diagnosis of first acute ST segment elevation myocardial infarction presenting within 24 hours from symptom onset, and eligible for reperfusion therapy. All patients received streptokinase in the usual dose regimen. Patients underwent resting high-quality 12-lead electrocardiogram recordings to calculate the modified QRS score and estimate the sum of ST segment elevation before (STE1) and 90 minutes after (STE2) streptokinase. The difference between STE1 and STE2 was then measured and accepted as the sum of ST segment resolution, expressed as SigmaSTR. Patients were classified into two groups: those with SigmaSTR > or = 50% of STE1 (the resolution group) and those with SigmaSTR < 50% (the non-resolution group).
RESULTS: The mean QRS score was significantly lower in the resolution group compared to the non-resolution group (2.88 +/- 1.34 vs 5.93 +/- 1.56, respectively, p < 0.001). There was a highly significant negative correlation between QRS score and SSTR with a correlation coefficient r = -0.76. Using a cut-off value of > or = 4, the QRS score had a sensitivity of 93%, specificity of 72%, positive and negative predictive values of 74% and 92% respectively, for predicting SigmaSTR < 50%.
CONCLUSIONS: The Selvester QRS score can reliably predict adequate ST segment resolution in patients with first acute ST segment elevation myocardial infarction receiving fibrinolytic therapy, with a high sensitivity and an acceptable specificity.
Zainab Abdel-Salam; Samir Wafa; Shaimaa Kamel; Wail Nammas
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Cardiology journal     Volume:  17     ISSN:  1897-5593     ISO Abbreviation:  Cardiol J     Publication Date:  2010  
Date Detail:
Created Date:  2010-08-06     Completed Date:  2010-11-22     Revised Date:  2011-03-14    
Medline Journal Info:
Nlm Unique ID:  101392712     Medline TA:  Cardiol J     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  367-73     Citation Subset:  IM    
Cardiology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
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MeSH Terms
Drug Administration Schedule
Fibrinolytic Agents / administration & dosage*
Health Status Indicators*
Infusions, Intravenous
Middle Aged
Myocardial Infarction / diagnosis,  drug therapy*
Predictive Value of Tests
Sensitivity and Specificity
Streptokinase / administration & dosage*
Thrombolytic Therapy*
Time Factors
Treatment Outcome
Reg. No./Substance:
0/Fibrinolytic Agents; EC 3.4.-/Streptokinase
Comment In:
Cardiol J. 2011;18(1):114-5; author reply 116   [PMID:  21305499 ]

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