To explore the evaluation value of the QRS-T angle on the electrocardiogram plane for the prognosis of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

The clinical data of 121 patients with NSTE-ACS who were treated in our hospital from March 2023 to March 2024 were retrospectively included. They were followed up for one consecutive year. The patients were divided into the good prognosis group and the poor prognosis group based on whether major adverse cardiac events occurred during the follow-up period. The clinical data and electrocardiogram parameters of the two groups were compared. Logistic regression was used to analyze the factors influencing the prognosis of patients with NSTE-ACS. Pearson correlation was used to analyze the relationship between the global registry of acute coronary events (GRACE) risk score, the level of high-sensitivity myocardial troponin I (hs-cTnI) at admission and the QRS-T angle on the electrocardiogram plane in patients with NSTE-ACS. The receiver operating characteristic (ROC) curve was applied to evaluate the value of GRACE risk score, the level of hs-cTnI at admission, and the QRS-T angle in predicting the prognosis of patients with NSTE-ACS.

Among 121 patients with NSTE-ACS, 35 major adverse cardiac events occurred, and the rate of major adverse cardiac events was 28.93%. The GRACE risk score, admission hs-cTnI level and QRS-T angle in the poor prognosis group were all higher than those in the good prognosis group (P<0.05). High GRACE risk score, high hs-cTnI level, and increased QRS-T angle are risk factors for poor prognosis in patients with NSTE-ACS (P<0.05); The GRACE risk score of patients with NSTE-ACS, the hs-cTnI level at admission and the QRS-T angle were moderately positively correlated (P<0.05). GRACE risk score, admission hs-cTnI level, and QRS-T angle all have certain predictive values for the poor prognosis of patients with NSTE-ACS. Among them, the combined detection of the three has the highest predictive efficacy, with an AUC of 0.931, a sensitivity of 97.14%, and a specificity of 72.09%.

The QRS-T angle on the electrocardiogram plane is significantly increased in patients with poor prognosis of NSTE-ACS. The increase in the QRS-T angle is a risk factor and predictor of poor prognosis in patients with NSTE-ACS, but it has the highest predictive efficacy when combined with GRACE risk score and admission hs-cTnI level.