Added Value of Modified Anderson–Wilkins Acuteness Score in Prognostication of Patients with Acute Myocardial Infarction

Aleksandar Serafimov; Hajber Taravari; Enes Shehu; Darko Kitanoski; Visar Miftari; Ljubica Georgievska-Ismail; Sasko Kedev; Marija Vavlukis

doi:10.3889/oamjms.2020.5425

Authors

Aleksandar Serafimov Department of Cardiology, Clinical Hospital Shtip, Faculty of Medical Sciences, University Goce Delchev, Shtip, Republic of Macedonia http://orcid.org/0000-0003-3638-1397
Hajber Taravari Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia
Enes Shehu Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia
Darko Kitanoski Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia
Visar Miftari Department of Neurology, Clinical Hospital Tetovo, Faculty of Medical Sciences, University of Tetovo, Tetovo, Republic of Macedonia
Ljubica Georgievska-Ismail Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia
Sasko Kedev Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia
Marija Vavlukis Department of Cardiology, University Clinic of Cardiology, Medical Faculty, Skopje, Republic of Macedonia

DOI:

https://doi.org/10.3889/oamjms.2020.5425

Keywords:

Electrocardiogram, myocardial infarction, modified Anderson Wilkins score of acuteness, percutaneous coronary intervention, neurohormonal activation, prognosis

Abstract

BACKGROUND: Electrocardiogram (ECG) signs on admission can serve as a prognostic marker in patients treated for myocardial infarction (MI).

AIM: The aim of the study was to determine the predictive role of modified Anderson–Wilkins (MAW) ECG score of acuteness on the extent of myocardial injury, left ventricular (LV) remodeling, and clinical outcome in patients with acute MI.

METHODS: Prospective, observational cohort study on patients treated for MI at the University Clinic for Cardiology. Subjects were analyzed for their demographic, clinical, ECG, LV functional, angiographic variables, course of treatment, and in-hospital outcome. MAW score was calculated for each patient. Patients were comparatively analyzed divided in two groups (score <3 and ≥3).

RESULTS: One hundred fifty patients (70% males and 30% females), aged 60.9 years were included in the study. Sixty-eight patients had MAW score <3 (mean 1.7), and 82 had score ≥3 (mean 3.5), p>0.001. Patients with ST-segment elevation MI had OR 2.1 (p>0.000), and patients with multiple locations (excluding anterior) had OR 2.1 (p > 0.000) of having MAW score ≥3. They received mechanical reperfusion 1.9 (p = 0.032) times more often. High MAW score was associated with stress hyperglycemia (OR 2.1; p = 0.032); low potassium (OR 2.8; p = 0.032), lower creatinine (p = 0.050), and higher NT-proBNP (OR 2.5; p = 0.050). High MAW score was associated with decreased LV function and increased LV dimensions on the follow-up echocardiography (p = 0.050 and 0.012, respectively).

CONCLUSION: ECG is an important prognostic tool in MI patients. ECG-derived MAW score demonstrates a strong correlation with stress hyperglycemia, potassium, creatinine, and natriuretic peptides level and can serve as an early marker of LV remodeling after MI.