open access

Vol 16, No 5 (2009)
Original articles
Published online: 2009-07-31
Submitted: 2013-01-14
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Distortion of the QRS in elderly patients with myocardial infarction

Juan C. García-Rubira, Iván Núnez-Gil, Rafael García-Borbolla, Vera Lennie, María C. Manzano, Miguel A. Cobos, Leopoldo Pérez de Isla, Antonio Fernández-Ortiz, Carlos Macaya
Cardiol J 2009;16(5):418-425.

open access

Vol 16, No 5 (2009)
Original articles
Published online: 2009-07-31
Submitted: 2013-01-14

Abstract

Background: Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age.
Methods and results: We analysed 634 consecutive patients (age 62.6 ± 13.7, 77% male) admitted in the first 12 hours of ST-elevation myocardial infarction. Two groups of age were defined: < 75 years-old and ≥ 75 years-old. Additionally, we defined two ECG groups according to the presence of ST segment elevation with distortion of the terminal portion of the QRS in two or more adjacent leads (QRS+) or the absence of this pattern (QRS–). Older people had more often QRS+ (30% vs. 20%, p = 0.023). The older group with QRS+ had an in-hospital mortality of 18%, vs. 7% with QRS– (p = 0.04), and an incidence of major adverse events of 40% vs. 14% (p = 0.002). In the multivariate analysis, age ≥ 75 years was an independent predictor of distortion of the QRS (odds ratio 2.1, 1.2–4.9, p = 0.016).
Conclusions: The distortion of the terminal portion of the QRS in myocardial infarction is more frequent in elderly people, and is significantly related to adverse prognosis. This ECG finding can be helpful to promptly stratify the risk in elderly patients

Abstract

Background: Distortion of the terminal portion of the QRS in the initial electrocardiogram (ECG) is a strong predictor of adverse outcome in myocardial infarction. Our purpose is to assess the relationship of distortion of QRS and other ECG characteristics with older age.
Methods and results: We analysed 634 consecutive patients (age 62.6 ± 13.7, 77% male) admitted in the first 12 hours of ST-elevation myocardial infarction. Two groups of age were defined: < 75 years-old and ≥ 75 years-old. Additionally, we defined two ECG groups according to the presence of ST segment elevation with distortion of the terminal portion of the QRS in two or more adjacent leads (QRS+) or the absence of this pattern (QRS–). Older people had more often QRS+ (30% vs. 20%, p = 0.023). The older group with QRS+ had an in-hospital mortality of 18%, vs. 7% with QRS– (p = 0.04), and an incidence of major adverse events of 40% vs. 14% (p = 0.002). In the multivariate analysis, age ≥ 75 years was an independent predictor of distortion of the QRS (odds ratio 2.1, 1.2–4.9, p = 0.016).
Conclusions: The distortion of the terminal portion of the QRS in myocardial infarction is more frequent in elderly people, and is significantly related to adverse prognosis. This ECG finding can be helpful to promptly stratify the risk in elderly patients
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Keywords

elderly; myocardial infarction; QRS distortion

About this article
Title

Distortion of the QRS in elderly patients with myocardial infarction

Journal

Cardiology Journal

Issue

Vol 16, No 5 (2009)

Pages

418-425

Published online

2009-07-31

Bibliographic record

Cardiol J 2009;16(5):418-425.

Keywords

elderly
myocardial infarction
QRS distortion

Authors

Juan C. García-Rubira
Iván Núnez-Gil
Rafael García-Borbolla
Vera Lennie
María C. Manzano
Miguel A. Cobos
Leopoldo Pérez de Isla
Antonio Fernández-Ortiz
Carlos Macaya

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