Efficacy and Safety of a Novel CCTA-Guided Algorithm for ED Assessment of Patients Presenting with Ischaemic-Type Chest Pain

Abstract

posed diagnostic criteria for ABS betweenMarch 2004 and December 2009. Twenty-twoof the cohortmetECGcriteria of anterior ST-elevation myocardial infarction. Twentytwo sex-matched patients with angiographic confirmed A-STEMI served as a control group. Results: Magnitude of ST elevation from V1-4 was significantly higher in A-STEMI compared to ASTE-ABS. Anterior abnormal Q wave (0% vs. 32%, p= 0.002) and V1 ST elevation (0% vs. 32%) are uncommon in ASTEABS.CombinedmaximalSTsegmentelevations ina single lead ≤3mm with absence of abnormal anterior Q wave have both sensitivity and specificity of 82% in differentiating ASTE-ABS fromA-STEMI. Combining the above with absence of V1 involvement further enhanced specificity to 95%. Conclusion: Our data support several ECG characteristics that distinguish ASTE-ABS from A-STEMI. These criteria need to be assessed in an independent cohort. doi:10.1016/j.hlc.2010.06.520