Prevalence and Clinical Implication of Wellens’ Sign in Patients With Non-ST-Segment Elevation Myocardial Infarction
| Autor: | Shunsuke Aoi, Akihiro Kobayashi, Naoki Misumida, Yumiko Kanei |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Coronary angiography
Wellens’ sign medicine.medical_specialty 030204 cardiovascular system & hematology Culprit Coronary artery disease 03 medical and health sciences 0302 clinical medicine Internal medicine T wave medicine ST segment Inverted t cardiovascular diseases Myocardial infarction Unstable angina business.industry LAD culprit medicine.disease NSTEMI 030220 oncology & carcinogenesis cardiovascular system Cardiology Original Article Cardiology and Cardiovascular Medicine business |
| Zdroj: | Cardiology Research |
| ISSN: | 1923-2837 1923-2829 |
| Popis: | Background: Symmetrically inverted or biphasic T waves in anterior precordial leads, Wellens' sign, have been shown to represent impending infarction of left anterior descending (LAD) territory among unstable angina patients in the studies published more than 3 decades ago, when non-ST-segment elevation myocardial infarction (NSTEMI) was not a recognized entity. The clinical implication of Wellens' sign in the contemporary NSTEMI cohort has not been clarified. Methods: We performed a retrospective analysis of all NSTEMI patients who underwent coronary angiography between January 2013 and June 2014. Wellens' sign was defined as either symmetrically inverted T waves (>= 0.10 mV) or biphasic T waves in both leads V2 and V3. Coronary angiograms were reviewed and culprit lesions were determined for each patient. Results: A total of 274 patients were included in the final analysis, of whom 24 (8.8%) had Wellens' sign. Among these 24 patients, 16 had a LAD culprit (eight proximal), two had a non-LAD culprit, and six had non-obstructive coronary artery disease. Patients with Wellens' sign were more likely to have LAD culprit (66.7% vs. 19.6%, P < 0.001) and proximal LAD culprit (33.3% vs. 14.4%, P = 0.035) than those without it. Wellens' sign had a sensitivity of 24.6% and a specificity of 96.2% to predict LAD culprit. Conclusions: Our study revealed that: 1) Wellens' sign was seen in 8.8% of the patients with NSTEMI; 2) Two-thirds of patients with Wellens' sign had LAD culprit and one-third had proximal LAD culprit; and 3) Sensitivity and specificity of Wellens' sign to predict LAD culprit were 24.6% and 96.2%, respectively. Cardiol Res. 2019;10(3):135-141 doi: https://doi.org/10.14740/cr856 |
| Databáze: | OpenAIRE |
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