ASSOCIATION BETWEEN TERMINAL QRS DISTORSION WITH GRACE SCORE IN ACUTE STEMI PATIENT IN HAJI ADAM MALIK HOSPITAL, MEDAN

Abstract

Background: Amount of 17.9 million people died from cardiovascular disease in 2016, half were caused by acute myocardial infarct. Terminal QRS distortion is showing the degree of ischemia in patients with severe STEMI. Risk stratification of the current ACS is carried out using the GRACE score as a validated predictor. Objective: The study objective is to determine the association between terminal QRS distortion in STEMI patients and the GRACE score, also to identify the risk of death through an ECG examination. Methods: The study involved STEMI patients who were hospitalized at Haji Adam Malik Hospital from May 2019 to March 2020. The first group was STEMI with terminal QRS distortion, and another group was without distortion. The association between terminal QRS distortion and independent parameters of GRACE score were observed, and monitoring was carried out for the next six months. The Kaplan-Meier curve performed survival analysis.

Results: From 60 STEMI patients, 45 patients (75%) with ST-elevation anterior and 26 (43.3%) patients with terminal QRS distortion (first group). It had a significant statistically GRACE score (130.92 ± 38.209, p = 0.001), compared to those without distortion. The GRACE score parameters to terminal QRS distortion were significantly associated (p <0.05). The first group also had poor clinical outcomes (Hazard Ratio 3,596; CI 95%) and the highest mortality rate over six months of follow-up.

Conclusion: The association between terminal QRS distortion and the GRACE might be considered as a potential tool for risk stratification in STEMI patients.