Electrocardiography changes in acute aortic dissection-association with troponin leak, coronary anatomy, and prognosis
| Autor: | Raziyeh Parizad, Mohammadreza Chavoshi, Kasra Kolahdouzan, Rezayat Parvizi, Leili Pourafkari, Samad Ghaffari, Nader D. Nader, Arezou Tajlil |
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| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Ischemia 030204 cardiovascular system & hematology Iran Coronary Angiography 03 medical and health sciences QRS complex Electrocardiography 0302 clinical medicine Risk Factors Internal medicine medicine Humans 030212 general & internal medicine Myocardial infarction Aged Retrospective Studies Aortic dissection medicine.diagnostic_test biology Aortic Aneurysm Thoracic business.industry ST elevation Hazard ratio General Medicine Odds ratio Middle Aged medicine.disease Prognosis Troponin Survival Rate Aortic Dissection Emergency Medicine Cardiology biology.protein Female business |
| Zdroj: | The American journal of emergency medicine. 34(8) |
| ISSN: | 1532-8171 |
| Popis: | Background Electrocardiography (ECG) offers some information that may be used to prognosticate acute type A aortic dissection (AAOD) for short- and long-term mortality. Methods We retrospectively analyzed the electrocardiograms of patients with AAOD admitted from March 2004 to March 2015. The frequency of ECG findings and their prognostic value on hospital and follow-up mortality were investigated. Findings pertaining to coronary involvement and troponin level were also examined. Results A total of 120 men and 64 women were admitted. Acute ischemic changes were reported in 38.0%, whereas T inversion was the most common recorded abnormality, which occurred in 38.6%. Acute ST-elevation myocardial infarction was detected in 16.3%. Troponin increased in 36.6%; 21.9% of the patients underwent coronary angiography among which 70% were normal. Coronary involvement or troponin increase was not different in patients with acute ECG changes. During hospitalization, 45.7% of the patients died. In multivariate analyses, ST elevation in lead aVR was associated with higher hospital death (odds ratio, 5.30; 95% confidence interval, 1.09-25.73; P = .038), whereas QRS greater than 120 milliseconds was associated with long-term mortality (hazard ratio, 2.45; 95% confidence interval, 1.25-3.76; P = .006). Conclusion Acute ischemic ECG changes are common in AAOD, and a completely normal ECG is infrequently encountered. Acute ECG changes were not associated with the increased troponin or the presence of coronary lesions in angiography. |
| Databáze: | OpenAIRE |
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