Electrocardiographic criteria for occlusive and prognostically unfavorable coronary artery disease

Since patients with occlusive coronary artery thrombosis benefit more from emergency reperfusion, after the widespread introduction of thrombolytic therapy, the concept of Q-wave and non-Q-wave myocardial infarction was replaced by the concept of ST-segment elevation (STE) and non-STE (NSTE) acute coronary syndrome (ACS). But at present, due to the spread of mechanical reperfusion, this concept does not seem to be fully perfect. The electrocardiographic (ECG) diagnostic method allows, among patients with NSTE-ACS, to identify a group of patients with occlusive and/or prognostically unfavorable hemodynamically significant coronary lesions, as well as to provide them with timely percutaneous coronary intervention as early as possible and to improve outcomes. This article rationales changing approaches to the management of patients with NSTE-ACS and analyzes in detail the currently known ECG criteria for occlusive and/or prognostically unfavorable coronary lesions.