A Novel Prehospital Electrocardiogram Score Predicts Myocardial Salvage in Patients with ST-Segment Elevation Myocardial Infarction Evaluated by Cardiac Magnetic Resonance


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Abstract

Objectives:We hypothesized that prehopsital ECG scores can identify ST-segment elevation myocardial infarction (STEMI) patients in whom time delay is particularly important for myocardial salvage.Methods:We evaluated the Anderson-Wilkins (AW) score (which designates the acuteness of ischemia) and grade 3 ischemia (GI3) (which identifies severe ischemia) in the prehospital ECG and compared them to the myocardial salvage index (MSI) assessed by cardiac magnetic resonance.Results:In 150 patients, system delay (alarm to balloon inflation) (β = -0.304, p < 0.001) and AW score (β = 0.364, p < 0.001) correlated with MSI. AW scores ≥3 (p < 0.001) and GI3 (p = 0.002) predicted the MSI. We formed 4 subgroups combining AW scores (<3 or ≥3) and grades of ischemia (Conclusion:In patients with STEMI, the novel prehospital salvage score identifies subgroups in which myocardial salvage is particularly time dependent.

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