Angiographic and clinical outcomes among patients with acute coronary syndromes presenting with isolated anterior ST-segment depression

Abstract

Objectives To evaluate both angiographic and clinical outcomes in patients with acute coronary syndrome (ACS) presenting with isolated anterior ST-segment depression on 12-lead ECG. Background ACS is an umbrella term used to cover a spectrum of events caused by acute myocardial ischemia. Patients and methods The study included 50 consecutive patients with ACS. All patients had isolated ST depression in the anterior leads on admission ECG. Coronary angiography and assessment of cardiac biomarkers were performed at baseline. According to TIMI flow grade in the culprit artery and the result of cardiac markers, patients were subdivided into three groups: group I: TIMI flow grade 0/1 and positive markers, group II: thrombolysis in myocardial infarction (TIMI) flow grade 2/3 and positive markers, and group III: TIMI flow grade 2/3 and negative markers. In-hospital and 30-day outcome were reported. Results On the basis of coronary angiography findings and results of cardiac markers, 12 patients (24%) had totally occluded culprit artery plus positive markers (group I) and 10 patients (20%) had TIMI flow II/III plus subtotal occlusion in the culprit artery and positive markers (group II), whereas 28 patients (56%) patients had TIMI flow II/III and negative markers (group III). In-hospital and 30-day outcomes did not differ between groups. Conclusion Among patients with ACS presenting with isolated anterior ST-segment depression, about one-quarter had an occluded culprit artery and elevated cardiac markers.