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Selvester Score in Myocardial Infarction, Could It Predict Degree of Severity in Coronary Lesion?

Author : H. Pribadi, J. A. Pangemanan, S. H. Rampengan, A. L. Panda, I. Adriana, Ronaldi, V. F. K. Candra, N
Upload Date : 19-04-2018

Background: Electrocardiogram which was invented by Einthoven in 1912 is still recommended because of non-invasiveness and cost efectiveness in diagnosing myocardial Infarction (MI). Selvester score calculate the QRS wave in ECG to predict the location of MI and total score point may contribute to predict the degree of infarction.  In 1972, Selvester firstly pronounced scoring system with 57 criteria that could predict the damage in left ventricle after MI. The last revision of this scoring system in 2009 had made this Selvester Score be available for conduction problem ECG. Rupture of plaque causing thrombotic and obstructive changes in coronary lumen and the degree of obstruction differ the type of MI. ESC guidelines 2017 recommend electrocardiogram should be taken under 10 minutes in patient that is suspected to have MI. Coronary angiography is a gold standard to detect the severity of coronary lession and recommended by ESC. This study focus on determining the relationship between Selvester Score with degree of coronary lesion.

Methods: Using cross sectional analytic observational statistic, this study was conducted in July till September 2017 at Prof Kandou General Hospital. Sixty patient who diagnosed with acute MI were analyzed their ECG using Selvester score and admited to have coronary angiography to determine the degree of coronary lesion using Modified Gensini.

Result: High Selvester Score was found in 28 patient (46,7%), moderate in 21 patient (35%), and 11 patient (18,3%) have low score. In coronary angiography study using Modified Gensini Score, the score was severe in 10 patient (16,7%), moderate in 38 (63,3%), and mild in 12 patient (20%). Statistical analysis using Spearman test showed relationship between Selvester Score and degree of coronary lesion (p=0.028 and r=0.283).

Conclusion: This study concluded that patient with higher Selvester Score will have higher degree of coronary lesion.

KEYWORDS : Selvester Score, Gensini, Coronary Lesion, Myocardial Infarction


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