Electrocardiographic findings in true acute left main coronary total occlusion a subanalisys from ATOLMA registry
| Autor: | Ricardo Zayas-Rueda, Rafael Vázquez-García, Livia L. Gheorghe, D. Mialdea-Salmerón, Dolores Cañadas-Pruaño, D. Garcia-Molinero, R. Toro, Alejandro Gutierrez-Barrios, Germán Calle-Pérez |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.diagnostic_test business.industry Bundle-Branch Block Myocardial Infarction medicine.disease QT interval Bifascicular block QRS complex Electrocardiography medicine.anatomical_structure Coronary Occlusion Internal medicine Occlusion medicine Cardiology Left axis deviation Humans cardiovascular diseases Myocardial infarction Registries Cardiology and Cardiovascular Medicine business Artery |
| Zdroj: | Journal of electrocardiology. 68 |
| ISSN: | 1532-8430 |
| Popis: | Introduction Acute total occlusion of the left main coronary artery (ATOLMA) usually leads to a catastrophic presentation. Prediction of ATOLMA by electrocardiogram (ECG) may contribute to early detection and reperfusion. Limited data have been reported previously. This study aims to identify the admission 12‑leads ECG features that can predict the presence of ATOLMA and in-Hospital mortality in these patients. Methods The admission ECGs findings in 24 patients from the previously reported ATOLMA multicenter registry were compared to the ECGs findings in 15 patients with an acute subtotal occlusion of the left main (ASOLMA) and to 15 patients with anterior ST-elevation myocardial infarction of the proximal left anterior descending (LADp-STEMI). Results Some ECG features at presentation can predict an ATOLMA: QRS left axis deviation (−61.17 ± 9 degrees); ST-segment elevation in aVL (1.9 ± 0.65 mm); absence of ST-segment elevation in V1 (0.0 ± 0.6 mm); bifascicular block (58%); fragmented QRS (62.5%); prolongation of QTc interval (465 ± 19 ms) and of QRS interval (136 ± 12 mm). The multivariate analysis found that the independent predictors to distinguish ATOLMA from ASOLMA were aVL ST-segment deviation (OR 5.6(95% CI 1.5–21), p = 0.01) and absence of V1 ST-segment elevation (OR 27(95% CI 1.4–52), p = 0.01); and from LADp-STEMI was QRS width (OR 1.1(95% CI 1.02–1.2), p = 0.02). Fragmented QRS was the only independent predictor of in-hospital mortality in ATOLMA (OR 0.125(95% CI 0.01–0.81), p = 0.03). Conclusions aVL ST-segment elevation, the absence of V1 ST-segment elevation, left axis deviation, the presence of bifascicular block, and prolongation of QRS and QTc interval are predictors of ATOLMA. Fragmented QRS predicts in-hospital mortality in ATOLMA. |
| Databáze: | OpenAIRE |
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