Key result
Aslanger pattern shows no significant link to increased in-hospital mortality in non-STEMI inferior MI.
Why the study?
In acute inferior myocardial infarction with the Aslanger pattern, hemodynamic characteristics and prognostic features such as in-hospital mortality had not yet been clarified.
Does the Aslanger pattern on ECG predict multivessel disease, hemodynamic collapse, and in-hospital mortality in patients with acute inferior myocardial infarction?
Observational (n=72)
No
Does the Aslanger pattern on ECG predict multivessel disease, hemodynamic collapse, and in-hospital mortality in patients with acute inferior myocardial infarction?
The Aslanger pattern on ECG identifies a high-risk subset of NSTEMI patients with acute inferior myocardial infarction who frequently have multivessel disease and are at increased risk for hemodynamic collapse and in-hospital mortality.
BACKGROUND: ST-elevation is one of the most valuable electrocardiogram findings to diagnose acute myocardial infarction. However, more than a quarter of acute coronary occlusions are missed by this criterion, causing a delay in revascularization. Therefore, there should be awareness of the limitations of the current criteria and new electrocardiographic findings are required as a diagnostic tool to compensate for them. The Aslanger pattern is a specific electrocardiographic finding in acute inferior myocardial infarction with multivessel disease and allows the detection of inferior myocardial infarction that does not show ST-elevation, leading to rapid revascularization. However, in patients with the Aslanger pattern, the hemodynamic characteristics, such as the rate of shock and the use of mechanical circulatory support, as well as prognostic characteristics such as the in-hospital mortality rate, have not yet been clarified. METHODS: In this study, we retrospectively surveyed the current practice on the basis of ST-elevation myocardial infarction (STEMI) criteria in patients with acute coronary artery occlusion presenting with inferior myocardial infarction. We examined the clinical characteristics of the Aslanger pattern. RESULTS: Based on the STEMI criteria, 71.8% (51/72) of patients were diagnosed with STEMI from an acute electrocardiogram, and 28.2% (21/78) were diagnosed with non-STEMI. As expected, ruling out in all acute coronary artery occlusions using STEMI criteria alone was difficult. A total of 48% of patients with non-STEMI had the Aslanger pattern. In addition, 80% of patients with the Aslanger pattern had multivessel disease, 30% had the use of the mechanical circulatory support, and 20% had in-hospital mortality. CONCLUSION: This study suggests that the Aslanger pattern is useful not only for diagnosis, but also for predicting hemodynamic collapse and a poor prognosis. Therefore, we should share information on Aslanger pattern with other physicians and use this pattern in daily practice.
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Miyauchi et al. (2023) conducted an observational in Acute inferior myocardial infarction (n=72). Aslanger pattern vs. Without Aslanger pattern was evaluated on In-hospital mortality (p=0.21). In patients with acute inferior myocardial infarction not meeting STEMI criteria, the Aslanger pattern was present in 50% of cases and was associated with a 20% in-hospital mortality rate.
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