PT  - JOURNAL ARTICLE
AU  - Tiller, Christina
AU  - Holzknecht, Magdalena
AU  - Reindl, Martin
AU  - Lechner, Ivan
AU  - Kalles, Verena
AU  - Troger, Felix
AU  - Schwaiger, Johannes
AU  - Mayr, Agnes
AU  - Klug, Gert
AU  - Brenner, Christoph
AU  - Bauer, Axel
AU  - Metzler, Bernhard
AU  - Reinstadler, Sebastian Johannes
TI  - Estimating the extent of myocardial damage in patients with STEMI using the DETERMINE score
AID  - 10.1136/openhrt-2020-001538
DP  - 2021 Feb 01
TA  - Open Heart
PG  - e001538
VI  - 8
IP  - 1
4099  - http://openheart.bmj.com/content/8/1/e001538.short
4100  - http://openheart.bmj.com/content/8/1/e001538.full
SO  - Open Heart2021 Feb 01; 8
AB  - Background Recently, a simple ECG score (DETERMINE score) has been proposed for estimating myocardial scar in patients with ischaemic cardiomyopathy. We sought to evaluate the usefulness of the DETERMINE score for the assessment of myocardial infarct size (IS) as well as microvascular obstruction (MVO), in the setting of ST-elevation myocardial infarction (STEMI).Methods This observational study enrolled 423 patients with STEMI (median age 56, 17% women), revascularised by primary percutaneous coronary intervention (PCI). For evaluation of the DETERMINE and Selvester scoring system (an established but complex ECG score for IS estimation), ECG was conducted before discharge (median: 4 (IQR 2–6) days). Cardiac magnetic resonance (CMR) was conducted within a week after infarction for determination of IS and MVO.Results Median DETERMINE score of the overall cohort was 8 points (IQR 5–11). A higher DETERMINE score was significantly associated with a larger IS (21% vs 11% of left ventricular myocardial mass (LVMM), p<0.001) as well as larger MVO (1.2% vs 0.0% of LVMM, p<0.001). In linear and binary multivariable logistic regression analysis, the DETERMINE score remained independently associated with IS (OR 1.09, 95% CI 1.02 to 1.17, p=0.014) and MVO (OR 1.12, 95% CI 1.04 to 1.21, p=0.003), after adjustment for Selvester score and clinical indicators of IS (high-sensitivity cardiac troponin T, high-sensitivity C reactive protein, N-terminal pro-B-type natriuretic peptide, TIMI flow pre-interventional and post-interventional PCI, anterior infarct localisation).Conclusions In patients undergoing PCI for STEMI, the DETERMINE score provides an easy and inexpensive tool for appropriate estimation of infarct severity as determined by CMR.