Why the study?
Early recognition of subtle ECG changes resembling Wellens sign in patients with chest pain is crucial because it reflects a large area of myocardium at risk.
Wellens syndrome is a high-risk pre-infarction state predominantly involving the LAD, for which conventional risk scores like GRACE may underestimate clinical risk.
Early recognition of subtle ECG changes resembling Wellens sign in patients with chest pain is crucial as it reflects a large area of myocardium at risk. In our study, the culprit coronary artery was most frequently LAD (62.03%), with 36.7% proximal LAD culprit lesion, followed by LM (12.66%). Wellens syndrome should be considered a high risk condition that makes the conventional methods for risk assesment using risk scores unnecessary, useless and potentially deleterious. In our study, according to GRACE 1.0 risk score, 70.89% of patients were in the low risk group (1-108 points, estimated in-hospital death risk < 1%). No patient died during the initial hospitalization. All-cause mortality rate at six months was 7.59%, with 5.06% cardiovascular deaths.
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Avram et al. (2021) studied this question.
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