关键词: 冠心病, 立体心电图, 空间QRS?T夹角, 冠状动脉狭窄, 主要不良心脏事件

Abstract:

Objective To investigate the relationship between QRS⁃T angle and coronary artery disease（CHD）and its predictive value for MACE after PCI. Methods 180 patients with CHD admitted to our hospitalwere selected as the case group，and 85 non⁃CHD were selected as the control group. All patients underwent thethree⁃dimensional electrocardiogram to measure spatial QRS⁃T angle. According to the Gensini score，the casegroup were divided into three group，mild subgroup，moderate subgroup and severe subgroup. 174 patients who un⁃derwent PCI were followed up for 6 months. The spatial QRS⁃T angle and composition ratio between groups werecompared and analyzed. Explore the relationship between spatial QRS⁃T angle and MACE in patients after PCI. Results The Spatial QRS⁃T angle of the case group was larger than the control group［（91.86 ± 45.67）° vs.（50.83 ± 40.58）°，P＜0.05］. The ratio of QRS⁃T angle > 100° in the severe subgroup was higher than that in themild subgroup（76.9% vs. 39.7 %）and moderate subgroup（76.9% vs. 42.3%）. Logistic regression analysis resultsshowed that，QRS⁃T angle > 100° is a risk factor for MACE in patients with CHD after PCI（OR = 3.096，95%CI：1.106 ~ 8.671，P < 0.05）. The sensitivity and specificity of the QRS⁃T angle > 100° on the diagnosis of the severesubgroup with CHD were 76.9% and 59.1%，the area under ROC curve was 0.680（95%CI：0.600 ~ 0.761，P <0.05）.The sensitivity and specificity of the QRS⁃T angle > 100° on prediction MACE was 70.5% and 52%，the areaunder ROC curve was 0.612（95%CI：0.517 ~ 0.708，P = 0.027）. Conclusions QRS⁃T angle > 100° has certainclinical value on preliminary assessment of the degree of coronary stenosis ，and on prediction MACE after PCI.

Key words: coronary heart disease, three?dimensional electrocardiogram, spatial QRS?T angle, cor?onary artery stenosis, MACE