Abstract
Our objective was to determine the diagnostic significance of a low T-wave amplitude (TWA) and T/R ratio, defined as the amplitude ratio between the T waves and the R waves, in patients with acute non-ST elevation myocardial infarction (ANSTEMI). Syntax score (SS) shows the extension of coronary artery disease. Previously, low TWA and T/R ratios were demonstrated to be inversely proportional to the risk of sudden cardiac arrest in different cardiac disease conditions. 266 patients were retrospectively included with ANSTEMI between July 2021 and December 2022. SS-1 and SS-2 scores were calculated using the angiographic and clinical data of the patients. The patients were stratified into tertiles based on their median SS-1 scores as lower, moderate, and higher SS-1 tertiles. ECG parameters, including TWAs and T/R ratios in leads II and V5, were measured digitally. TWA and T/R ratios were compared with SSs among the tertiles. TWA and T/R ratios in leads II and V5 were significantly lower across the increasing SS-1 tertiles (p<0.001 for TWA in lead II) (p<0.001 for T/R ratio in lead II) (p=0.014 for TWA in lead V5) (p=0.002 for T/R ratio in lead V5).ROC analysis identified T/R ratios in leads II and V5 of 0.254 (AUC: 0.758, p<0.001) and 0.201 (AUC: 0.635, p<0.015), respectively. A low T/R ratio, particularly in lead II due to its greater AUC, better predicts moderate-to-high SS-1 in patients with ANSTEMI.
Published Version
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