Key result
Lead aVR STE >0.5 mm links to over double the rate of LM or 3VD in NSTE-ACS.
Why the study?
Electrocardiography's applicability in predicting left main coronary artery or three vessel disease in patients with Non-ST segment elevation acute coronary syndrome was not well established.
Cross-Sectional (n=114)
No
Absolute Event Rate: 62.96% vs 27.27%
p-value: p=<0.0001
May flag extensive CAD in NSTE-ACS; hypothesis-generating and should not yet change practice or guidelines.
BACKGROUND: Electrocardiography (ECG) is simple, quick and economic investigation for diagnosis of acute coronary syndrome.Its applicability in prediction of left main coronary artery/ 3 vessel coronary disease can be of very useful in saving precious time in the critical care of coronary patients.OBJECTIVE: Electrocardiography changes as a predictor of left main coronary artery / 3 vessel coronary disease in patients presenting with Non-ST segment elevation acute coronary syndrome.METHODOLOGY: This cross sectional study was executed from July 2014 to June 2015 at Isra University hospital Hyderabad taking 114 consecutive patients of age >20, of either gender, presenting with symptoms of Non-ST segment elevation MI or that showed ECG changes in lead aVR.Informed written consent for the study was taken from the immediate family members of patients.Approval from ethics review committee of Isra University was taken.Data analysis was done through SPSS.Descriptive statistics (Mean ±standard deviation for continuous & frequencies and percentages for categorical variables) were expressed.RESULTS: Patients' mean ±SD age was 56.65 ±15.44 years (Range: 20-89 years).Male to female ratio was 3.4:1.More than a half (52%) of these patients had Left main (LM) / 3 vessels disease.About a quarter other (25%) had 2 vessels while (22%) had single vessel disease (P value <0.0001).Patients having ST elevation in lead aVR, were associated with increased risk of developing LM / three vessels disease (P value <0.0001).CONCLUSION: ST elevation in lead aVR and ST depression in leads II, III, and aVF can be practically used for evaluation left main / 3 vessel disease among NSTE-ACS patients.
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A 2016 study conducted a cross-sectional in Non-ST Segment Elevation Acute Coronary Syndrome (NSTE-ACS) (n=114). ST segment elevation >0.5 mm in lead aVR vs. No ST segment elevation >0.5 mm in lead aVR was evaluated on Presence of Left Main (LM) / 3-vessel disease (p=<0.0001). ST elevation >0.5 mm in lead aVR was significantly associated with a higher frequency of left main or three-vessel disease in patients with NSTE-ACS (63% vs 27%, p<0.0001).
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