What is the predictive value of ST segment depression in inferior leads in first acute anterior myocardial infarction?
| Autor: | Muhammed Keskin, Ahmet İlker Tekkeşin, Ahmet Okan Uzun, Ceyhan Türkkan, Mert İlker Hayıroğlu, Ömer Kozan |
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| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment 030204 cardiovascular system & hematology Coronary Angiography Risk Assessment Electrocardiography 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine medicine Humans ST segment Hospital Mortality Prospective Studies 030212 general & internal medicine Anterior Wall Myocardial Infarction Depression (differential diagnoses) ST depression Univariate analysis medicine.diagnostic_test business.industry Percutaneous coronary intervention Middle Aged Acute anterior myocardial infarction Prognosis Predictive value Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Biomarkers |
| Zdroj: | Journal of Electrocardiology. 51:524-530 |
| ISSN: | 0022-0736 |
| Popis: | Electrical phenomenon and remote myocardial ischemia are the main factors of ST segment depression in inferior leads in acute anterior myocardial infarction (AAMI). We investigated the prognostic value of the sum of ST segment depression amplitudes in inferior leads in patients with first AAMI treated with primary percutaneous coronary intervention. (PPCI).In this prospective analysis, we evaluated the in-hospital prognostic impact of the sum of ST segment depression in inferior leads on 206 patients with first AAMI. Patients were stratified by tertiles of the sum of admission ST segment depression in inferior leads. Clinical outcomes were compared between those tertiles.Univariate analysis revealed higher rate of in-hospital death for patients with ST segment depression in inferior leads in tertile 3, as compared to patients in tertile 1 (OR 9.8, 95% CI 1.5-78.2, p0.001). After adjustment for baseline variables, ST segment depression in inferior leads in tertile 3 was associated with 5.7-fold hazard of in-hospital death (OR: 5.7, 95% CI 1.2-35.1, p0.001). Spearman rank correlation test revealed correlation between the sum of ST segment depression amplitude in inferior leads and the sum of ST segment elevation amplitude in V1-6, L1 and aVL. Multivessel disease and additional RCA stenosis were also detected more often in tertile 3.The sum of ST segment depression amplitude in inferior leads of admission ECG in patients with first AAMI treated with PPCI provide an independent prognostic marker of in-hospital outcomes. Our data suggest the sum of ST segment depression amplitude to be a simple, feasible and clinically applicable tool for rapid risk stratification in patients with first AAMI. |
| Databáze: | OpenAIRE |
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