Aslanger’s pattern in non-ST-elevation myocardial infarction: Prevalence and angiographic correlates in a Vietnamese single-center cohort

Objective: Aslanger's pattern is a recently described electrocardiographic sign that may indicate inferior myocardial ischemia in the absence of classic ST-segment elevation, potentially leading to under-recognition in patients with acute coronary syndrome (ACS).However, its prevalence and angiographic correlates remain poorly characterized, particularly in Southeast Asian populations.The objective of the study was to determine the prevalence of Aslanger's pattern and to explore its association with coronary angiographic findings and in-hospital outcomes among patients undergoing coronary angiography for suspected ACS.Methods: This retrospective single-center study included 313 patients (153 non-ST-elevation myocardial infarction [NSTEMI], 160 without myocardial infarction) at a Vietnamese tertiary hospital.Admission electrocardiograms were independently reviewed by two blinded cardiologists using predefined criteria.Coronary angiographic characteristics, including culprit vessel involvement and the presence of multivessel disease, were analyzed.Results: Aslanger's pattern was identified in 9 patients (2.9%), including 8 patients in the NSTEMI group (5.2%) and 1 patient in the non-myocardial infarction group (0.6%).Among all cases in the NSTEMI group who exhibited the Aslanger's pattern, there was right coronary artery involvement and multivessel disease.Due to the small number of events, formal statistical comparisons were limited.In-hospital adverse events were infrequent, and no robust differences were observed between groups. Conclusion:In this cohort, Aslanger's pattern was uncommon but appeared more frequent in NSTEMI patients and was associated with right coronary artery involvement and multivessel disease.Given the small sample size, these findings should be considered hypothesis-generating.Larger multicenter studies are required to validate their diagnostic and prognostic significance.