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Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

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Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia. / Fakhri, Yama; Schoos, Mikkel Malby; Sejersten, Maria; Ersbøll, Mads; Valeur, Nana; Køber, Lars; Hassager, Christian; Wagner, Galen S; Kastrup, Jens; Clemmensen, Peter.

In: J ELECTROCARDIOL, Vol. 50, No. 1, 27.11.2016, p. 90-96.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Fakhri, Y, Schoos, MM, Sejersten, M, Ersbøll, M, Valeur, N, Køber, L, Hassager, C, Wagner, GS, Kastrup, J & Clemmensen, P 2016, 'Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia', J ELECTROCARDIOL, vol. 50, no. 1, pp. 90-96. https://doi.org/10.1016/j.jelectrocard.2016.11.002

APA

Fakhri, Y., Schoos, M. M., Sejersten, M., Ersbøll, M., Valeur, N., Køber, L., Hassager, C., Wagner, G. S., Kastrup, J., & Clemmensen, P. (2016). Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia. J ELECTROCARDIOL, 50(1), 90-96. https://doi.org/10.1016/j.jelectrocard.2016.11.002

Vancouver

Fakhri Y, Schoos MM, Sejersten M, Ersbøll M, Valeur N, Køber L et al. Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia. J ELECTROCARDIOL. 2016 Nov 27;50(1):90-96. https://doi.org/10.1016/j.jelectrocard.2016.11.002

Bibtex

@article{1035d151086045329385fab6617ff751,
title = "Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia",
abstract = "BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia.METHODS: In 186 STEMI patients treated with primary percutaneous coronary intervention (pPCI), the severity of ischemia (according to Sclarovsky-Birnbaum severity grades of ischemia) and the acuteness-score were obtained from prehospital ECG. Patients were classified according to the presence of severe ischemia or non-severe ischemia and acute ischemia or non-acute ischemia. Plasma NT-proBNP (pmol/L) was obtained after pPCI within 24hours of admission and was correlated with the acuteness-score.RESULTS: NT-proBNP levels were median (25th-75th interquartile) 112 (51-219) pmol/L in patients with non-severe ischemia (71.5%) and 145 (79-339) in patients with severe ischemia (28.5%) (p=0.074). NT-proBNP levels were highest in patients with severe and non-acute ischemia compared to those with severe and acute ischemia (182 (98-339) pmol/L vs 105 (28-324) pmol/L, p=0.012). There was a negative correlation between acuteness-score and log(NT-proBNP) in patients with severe ischemia (r=0.395, p=0.003), which remained significant in multilinear regression analysis (β=-0.155, p=0.007). No correlation was observed between the acuteness-score and log(NT-proBNP) in patients with non-severe ischemia (p=0.529) or in the entire population (p=0.187).CONCLUSION: In STEMI patients with severe ischemia, neurohormonal activation is inversely associated with ECG patterns of acute myocardial ischemia.",
keywords = "Acute Disease, Biomarkers/blood, Denmark, Electrocardiography/methods, Emergency Medical Services/statistics & numerical data, Female, Humans, Incidence, Male, Middle Aged, Myocardial Ischemia/blood, Natriuretic Peptide, Brain/blood, Peptide Fragments/blood, Reproducibility of Results, Risk Assessment/methods, Risk Factors, ST Elevation Myocardial Infarction/blood, Sensitivity and Specificity, Severity of Illness Index",
author = "Yama Fakhri and Schoos, {Mikkel Malby} and Maria Sejersten and Mads Ersb{\o}ll and Nana Valeur and Lars K{\o}ber and Christian Hassager and Wagner, {Galen S} and Jens Kastrup and Peter Clemmensen",
note = "Copyright {\textcopyright} 2016 Elsevier Inc. All rights reserved.",
year = "2016",
month = nov,
day = "27",
doi = "10.1016/j.jelectrocard.2016.11.002",
language = "English",
volume = "50",
pages = "90--96",
journal = "J ELECTROCARDIOL",
issn = "0022-0736",
publisher = "Churchill Livingstone",
number = "1",

}

RIS

TY - JOUR

T1 - Prehospital electrocardiographic acuteness score of ischemia is inversely associated with neurohormonal activation in STEMI patients with severe ischemia

AU - Fakhri, Yama

AU - Schoos, Mikkel Malby

AU - Sejersten, Maria

AU - Ersbøll, Mads

AU - Valeur, Nana

AU - Køber, Lars

AU - Hassager, Christian

AU - Wagner, Galen S

AU - Kastrup, Jens

AU - Clemmensen, Peter

N1 - Copyright © 2016 Elsevier Inc. All rights reserved.

PY - 2016/11/27

Y1 - 2016/11/27

N2 - BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia.METHODS: In 186 STEMI patients treated with primary percutaneous coronary intervention (pPCI), the severity of ischemia (according to Sclarovsky-Birnbaum severity grades of ischemia) and the acuteness-score were obtained from prehospital ECG. Patients were classified according to the presence of severe ischemia or non-severe ischemia and acute ischemia or non-acute ischemia. Plasma NT-proBNP (pmol/L) was obtained after pPCI within 24hours of admission and was correlated with the acuteness-score.RESULTS: NT-proBNP levels were median (25th-75th interquartile) 112 (51-219) pmol/L in patients with non-severe ischemia (71.5%) and 145 (79-339) in patients with severe ischemia (28.5%) (p=0.074). NT-proBNP levels were highest in patients with severe and non-acute ischemia compared to those with severe and acute ischemia (182 (98-339) pmol/L vs 105 (28-324) pmol/L, p=0.012). There was a negative correlation between acuteness-score and log(NT-proBNP) in patients with severe ischemia (r=0.395, p=0.003), which remained significant in multilinear regression analysis (β=-0.155, p=0.007). No correlation was observed between the acuteness-score and log(NT-proBNP) in patients with non-severe ischemia (p=0.529) or in the entire population (p=0.187).CONCLUSION: In STEMI patients with severe ischemia, neurohormonal activation is inversely associated with ECG patterns of acute myocardial ischemia.

AB - BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia.METHODS: In 186 STEMI patients treated with primary percutaneous coronary intervention (pPCI), the severity of ischemia (according to Sclarovsky-Birnbaum severity grades of ischemia) and the acuteness-score were obtained from prehospital ECG. Patients were classified according to the presence of severe ischemia or non-severe ischemia and acute ischemia or non-acute ischemia. Plasma NT-proBNP (pmol/L) was obtained after pPCI within 24hours of admission and was correlated with the acuteness-score.RESULTS: NT-proBNP levels were median (25th-75th interquartile) 112 (51-219) pmol/L in patients with non-severe ischemia (71.5%) and 145 (79-339) in patients with severe ischemia (28.5%) (p=0.074). NT-proBNP levels were highest in patients with severe and non-acute ischemia compared to those with severe and acute ischemia (182 (98-339) pmol/L vs 105 (28-324) pmol/L, p=0.012). There was a negative correlation between acuteness-score and log(NT-proBNP) in patients with severe ischemia (r=0.395, p=0.003), which remained significant in multilinear regression analysis (β=-0.155, p=0.007). No correlation was observed between the acuteness-score and log(NT-proBNP) in patients with non-severe ischemia (p=0.529) or in the entire population (p=0.187).CONCLUSION: In STEMI patients with severe ischemia, neurohormonal activation is inversely associated with ECG patterns of acute myocardial ischemia.

KW - Acute Disease

KW - Biomarkers/blood

KW - Denmark

KW - Electrocardiography/methods

KW - Emergency Medical Services/statistics & numerical data

KW - Female

KW - Humans

KW - Incidence

KW - Male

KW - Middle Aged

KW - Myocardial Ischemia/blood

KW - Natriuretic Peptide, Brain/blood

KW - Peptide Fragments/blood

KW - Reproducibility of Results

KW - Risk Assessment/methods

KW - Risk Factors

KW - ST Elevation Myocardial Infarction/blood

KW - Sensitivity and Specificity

KW - Severity of Illness Index

U2 - 10.1016/j.jelectrocard.2016.11.002

DO - 10.1016/j.jelectrocard.2016.11.002

M3 - SCORING: Journal article

C2 - 27887720

VL - 50

SP - 90

EP - 96

JO - J ELECTROCARDIOL

JF - J ELECTROCARDIOL

SN - 0022-0736

IS - 1

ER -