Abstract

adjudicators blinded to the angiogram results. RESULTS: 528 cardiac catheterizations were performed on PM patients presenting with ACS. After excluding patients without ventricular pacing on the ECG, 157 cases were included. Of the 157 cases, 16 (10.2%) met at least one SC (10 cases had > 5 mm of discordant ST elevation; 6 cases had > 1 mm of ST depression in leads V1, V2, or V3) while 147 did not meet any SC criteria. Baseline clinical characteristics were similar between the groups except for an increased prevalence of peripheral vascular disease in the SC group (53.9% vs. 17.5%; p1⁄40.002). The proportion of patients with positive troponin levels was similar between the groups. Patients meeting SC had a greater incidence of significant left main (LM) coronary disease at the time of cardiac catheterization (31.3% vs. 12.1%; p1⁄40.04; see Figure). There were no significant differences in revascularization strategy (medical therapy vs. PCI vs. CABG) between the groups. CONCLUSION: Among paced patients presenting with ACS, only a small proportion of patients met SC. However, a greater proportion of patients who met SC were found to have significant LM disease at the time of cardiac catheterization compared to those patients who did not meet SC.

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