Is the Frontal QRS-T Angle Successful in Differentiating Acute Coronary Syndromes?

INTRODUCTION: Acute coronary syndromes (ACS) encompass a spectrum of clinical conditions that result from a sudden occlusion or severe narrowing of the coronary arteries, leading to myocardial ischemia. The frontal QRS-T angle, a parameter measured on the electrocardiogram (ECG), has been proposed as a potential marker for cardiovascular events. This study aims to evaluate the effectiveness of the frontal QRS-T angle in differentiating between various subtypes of ACS (STEMI, non-STEMI, USAP) and stable angina pectoris (SAP).
METHODS: A prospective observational study was conducted on patients admitted to the emergency department between January 9, 2023, and January 3, 2024. The study population included patients diagnosed with ACS or SAP and a control group without cardiac pathology. The frontal QRS-T angle was calculated from 12-lead ECGs. Statistical analyses, including Kruskal-Wallis and ROC curve analysis, were performed to assess the diagnostic utility of the QRS-T angle.
RESULTS: The study included 169 patients, with a mean age of 61.96±13.90 years. The frontal QRS-T angle was significantly higher in the STEMI group compared to other groups. ROC analysis demonstrated that the QRS-T angle could significantly differentiate between non-cardiac patients and those with STEMI, non-STEMI, and USAP. The frontal QRS-T angle was also significant in predicting mortality, with a cutoff value of 58.00, AUC of 0.825, sensitivity of 84.20%, and specificity of 72.00%.
DISCUSSION AND CONCLUSION: The frontal QRS-T angle is a significant marker for distinguishing between different ACS subtypes and non-cardiac patients. Its role in identifying STEMI and predicting mortality highlights its potential utility in clinical practice.