Comparison of Electrocardiographic Parameters in Young and Middle-aged Patients Presenting with non-ST Myocardial Infarction

Objective: In this study, we aimed to examine the relationship between young and middle-aged patients and frontal QRS-T angle (FQRS-T A) by evaluating the demographic, clinical features and electrocardiographics (ECGs) of patients who presented with non-ST elevation myocardial infarction (NSTEMI).
Methods: The study was planned retrospectively, and 396 patients, young age (20-45 years, n=158) and middle-aged (46-65 years, n=238) who applied to the emergency department with chest pain and were diagnosed with NSTEMI underwent coronary angiography for the first time. The FQRS-T A is calculated by the frontal plane QRS axis and the T axis (FQRS-T A=QRS-T axis) from a 12-lead plane ECG.
Results: Hypertension (HT) (p<0.001) and diabetes mellitus (DM) (p<0.001), serum glucose (p=0.007), serum high-density lipoprotein cholesterol (HDL-C) level (p=0.005), SYNTAX score (p<0.001) and FQRS-T A (p<0.001) were higher in the middle-aged group. In multivariate analysis showed HT [odds ratio (OR): 4.084, 95% confidence interval (CI) (2.234-7.465), p<0.001], DM [OR: 1.452,95% CI (1.288-7.465), p=0.018], low HDL-C level [OR: 0.972, 95% CI (0.951-0.994), p=0.012], FQRS-T A [OR: 0.990, 95% CI (0.980-0.993), p<0.001], was determined as a possible independent risk factor for NSTEMI in middle-aged patients group. Analyzes showed that the optimal cut-off value for the degree of FQRS-T A to predict a middle-aged NSTEMI was >32.5%, with a sensitivity of 62% and a specificity of 52% (area under the curve: 0.633, 95% CI 0.579-0.687, p<0.001).
Conclusion: In our study, FQRS-T A was found to be higher in middle-aged NSTEMI patients, and it was found to be a possible independent risk factor for NSTEMI.