Q/R duration as a Predictor of No-Reflow in Patients with Acute Anterior Myocardial Infarction Who Underwent Primary Percutaneous Intervention

Author : P. Meidianaser, Andri, F. Harben, S. Masrul
Upload Date : 19-04-2018

Background: Acute transmural ischemia due to left anterior descending artery (LAD) occlusion changes precordial R and Q wave durations owing to depressed intramyocardial activation. We investigated the prognostic value of sum of precordial Q wave duration/sum of precordial R wave duration ratio (Q/R) in patients with first acute anterior myocardial infarction (AAMI) treated with primary percutaneous coronary intervention (PPCI). Coronary no-reflow (NR) following primary percutaneous coronary intervention (PPCI) is associated with worsened prognosis in patients with ST segment elevation myocardial infarction (STEMI).

Methods: In this retrospective analysis, we evaluated the no-reflow predictive value of Q/R on 30 patients with first AAMI from January 2017 – December 2017 at M. Djamil General Hospital Padang, Indonesia. Patients were divided into two as no-reflow group (n=5) and control (n=25) group according to post-PPCI flow status.

Results: The patients in the no-reflow group had significantly higher Q/R on admission electrocardiography (ECG) compared to patients in the control group (p <0.001). When admission ECG parameters were compared according to no-reflow prediction, Q/R was stronger than other well-accepted parameters.

Conclusion: In patients with first AAMI treated with PPCI, Q/R in admission ECG may have a role as an independent predictive marker of no-reflow.

KEYWORDS : Electrocardiography; Q wave; R wave; myocardial infarction; no-reflow

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