Why the study?
Assessment of coronary artery disease using ECG changes correlated with coronary angiographic findings is important for diagnosis and prognosis determination in CAD patients.
Does ECG accurately diagnose myocardial infarction or ischemia compared to coronary angiography in patients with suspected coronary artery disease?
Cross-Sectional (n=200)
Blinded evaluators
No
Does ECG accurately diagnose myocardial infarction or ischemia compared to coronary angiography in patients with suspected coronary artery disease?
Effect estimate: Sensitivity 87.50% to 96.63%, Specificity 91.30% to 95.45%
ECG is a highly sensitive and specific tool for diagnosing myocardial infarction or ischemia compared to the gold standard of coronary angiography.
BACKGROUNDCoronary Artery Disease (CAD) is the most common type of heart disease.Assessment of coronary artery disease (CAD) is the starting point of determination of prognosis of patients presenting with clinical symptoms.ECG reflects the physiology of the myocardium during ischemia, while Coronary Angiography identifies vessel anatomy.In the present study, we aimed to correlate ECG changes with coronary angiographic findings along with prediction of number of vessels involved in patients of coronary artery disease.This study also intended to determine sensitivity and specificity of ECG for diagnosis of coronary artery disease using CAG as gold standard. METHODSThis cross-sectional study was carried out for a period of 2 years at Acharya Vinobha Bhave Rural Hospital, a tertiary rural health institute.200 patients above 18 years of age who presented with or without symptoms and were willing for ECG and Angiography were included in study.Patients with valvular and congenital heart disease were excluded.Patients were divided into groups according to ECG changes and correlated with coronary angiography findings. RESULTSIn the present study, the sensitivity and specificity of ECG to diagnose myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 87.50% to 96.63% and 91.30% to 95.45%, respectively.Diagnostic accuracy of ECG to detect myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 89.36% to 96.40%. CONCLUSIONSECG is used as reliable tool for the diagnosis of coronary artery disease due to its high sensitivity and specificity, though CAG is the Gold Standard method for the diagnosis of CAD.
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Somani et al. (2020) conducted a cross-sectional in Coronary Artery Disease (n=200). Electrocardiogram (ECG) vs. Coronary Angiography (CAG) was evaluated on Diagnostic accuracy (sensitivity and specificity) of ECG to detect myocardial infarction or ischemia (Sensitivity 87.50% to 96.63%, Specificity 91.30% to 95.45%).
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