chapter  41
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The role of a Simplified Selvester Score as a predictor of successful fibrinolytics in STEMI

WithSyaifullah, I.N. Kaoy, Z. Mukhtar, H. Hasan, N.Z. Akbar, H.A.P. Lubis

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Fibrinolytics are one of the modalities of treatment for STEMI patients. Successful fibrinolytics have been associated with better clinical outcomes. We sought to explore whether the Simplified Selvester Score could predict successful fibrinolytic therapy electrocardiographically. Fifty-three STEMI patients who received fibrinolytic therapy with streptokinase were enrolled in this retrospective study. The Simplified Selvester Score was estimated on the first admission by ECG. STEMI patients were divided into two categories: successful or failed fibrinolytic therapy, based on ECG. The optimal cut-off Simplified Selvester Score was analysed. Patients with successful fibrinolytics have a lower Simplified Selvester Score (2.3 ± 1.6 vs 5.1 ± 1.7; p = 0.001). In multivariate analysis, a Simplified Selvester Score < 3.5 remained significantly associated with successful fibrinolytic therapy and appeared to be a strong predictor for successful fibrinolytic therapy (p = 0.004: OR = 6.8; 95% CI [1.55, 37.05]). A Simplified Selvester Score < 3.5 can be used as a predictor of successful fibrinolytic therapy in STEMI patients. Keywords: fibrinolytics, Selvester Score, STEMI