Key result
Left precordial ST-segment depression during acute inferior STEMI was associated with significantly higher in-hospital mortality compared to patients without such changes (10.18% vs 3.20%, p<0.001).
Why the study?
Does left precordial ST-segment depression on admission ECG predict worse in-hospital outcomes and more advanced coronary artery disease in patients with acute inferior STEMI undergoing primary PCI?
Cohort (n=1,374)
No
Does left precordial ST-segment depression on admission ECG predict worse in-hospital outcomes and more advanced coronary artery disease in patients with acute inferior STEMI undergoing primary PCI?
In patients with acute inferior STEMI undergoing primary PCI, left precordial ST-segment depression on admission ECG is a strong predictor of more advanced coronary artery disease and significantly higher in-hospital mortality.
Answers are grounded in this paper and cite their sources.
May refine risk stratification in inferior STEMI; hypothesis-generating and should not yet change practice.
Background The early identification of patients with acute inferior ST-segment elevation myocardial infarction (STEMI) with high risk features is particularly important. Acute inferior STEMI may be associated with ST-segment depression in the left precordial leads (V4–V6). This study assessed prognostic value of ST-segment depression in these left precordial leads during the admission of patients with acute inferior STEMI treated with primary percutaneous coronary intervention. Methods This retrospective study enrolled 1,374 patients with acute inferior STEMI who underwent primary percutaneous coronary angioplasty between March 2011 and June 2014. The patients were divided into two groups: one group ( n = 687) with left precordial ST-segment depression and the other ( n = 687) without such ST-segment changes. Results The patients with left precordial ST-segment depression were older and had higher incidence of hypertension, diabetes mellitus, and higher levels of troponin. In-hospital mortality was higher in patients with left precordial ST-segment depression. Advanced coronary artery disease was more observed in these patients. Conclusion In patients with acute inferior STEMI treated with primary coronary intervention, left precordial ST-segment depression during admission of ECG is associated with more advanced coronary artery disease, and worse in-hospital clinical outcomes.
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Namdar et al. (2018) conducted a cohort in Acute inferior ST-segment elevation myocardial infarction (STEMI) (n=1,374). Left precordial ST-segment depression (leads V4-V6) vs. Absence of left precordial ST-segment depression was evaluated on In-hospital mortality (p=<0.001). Left precordial ST-segment depression during acute inferior STEMI was associated with significantly higher in-hospital mortality compared to patients without such changes (10.18% vs 3.20%, p<0.001).
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