Key result
In patients with acute inferior STEMI, concomitant ST depression in anterior leads was significantly associated with the presence of left anterior descending artery lesions (55.88% vs 10%, p=0.02).
Why the study?
Electrocardiograms of acute ST elevation inferior myocardial infarction can show concomitant ST depression in anterior leads, but its significance on coronary angiograms required evaluation.
Does the presence of ST depression in anterior leads predict concomitant LAD lesions in patients with acute inferior STEMI?
Cross-Sectional (n=64)
No
Does the presence of ST depression in anterior leads predict concomitant LAD lesions in patients with acute inferior STEMI?
Absolute Event Rate: 55.88% vs 10%
p-value: p=0.02
In patients with acute inferior STEMI, the presence of ST depression in anterior leads is significantly associated with concomitant left anterior descending coronary artery disease.
May support ECG risk stratification in inferior STEMI; leaves open need for prospective validation before practice change.
Background and aims: Electrocardiogram of acute ST elevation inferior myocardial infarction can show concomitant ST depression in anterior leads. We aimed to see its significance on coronary angiogram. Methods: Cross sectional study conducted in Department of Cardiology of Shahid Gangalal National Heart Centre from March 2021 to June 2021. Total of 64 patients of acute inferior myocardial infarction were included consecutively. Electrocardiogram were analyzed for the presence of ST depression in anterior leads (V1-V6). Coronary angiogram were obtained. Linear regression analysis was applied to see correlations. Results: Thirty-four (53.12%) participants had significant ST depression in anterior leads. Their mean age was 64.53±11.67 years. Twenty-two (64.70%) were male. Out of them, 13 (38.23%) were hypertensive, 9 (26.47%) were smoker and 7 (20.58%) were diabetic. Among 30 (46.88%) participants without ST depression, mean age was 56.73±13.31 years and 21 (70%) were male. Out of them, 11 (36.66%) were hypertensive, 12 (40%) were smoker and 11 (33.66%) were diabetic. Culprit vessel was right coronary artery in 22 (64.70%) of those with ST depression and 22 (73.33%) of those without ST depression. Significant left anterior descending artery lesion was seen in 19 (55.88%) of those with ST depression and 3 (10%) of those without depression. Anterior ST depression showed positive correlation with left anterior descending artery lesion. Conclusion: ST depression in anterior leads in acute inferior myocardial infarction can be due to presence of concomitant left anterior descending coronary artery disease.
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Simkhada et al. (2021) conducted a cross-sectional in Acute inferior ST elevation myocardial infarction (STEMI) (n=64). ST depression in anterior leads vs. No ST depression in anterior leads was evaluated on Significant left anterior descending (LAD) artery lesion (≥ 70% luminal diameter stenosis) (p=0.02). In patients with acute inferior STEMI, concomitant ST depression in anterior leads was significantly associated with the presence of left anterior descending artery lesions (55.88% vs 10%, p=0.02).
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