Abstract
ST-segment shifts in lead aVR are associated with increased coronary atherosclerosis. However, there is insufficient data about the relationship between ST-segment shifts in lead aVR and coronary complexity. The aim of this study was to investigate this relationship. This prospective, observational study included 236 patients with acute coronary syndrome who underwent coronary angiography. Electrocardiograms on presentation were reviewed in terms of ST-segment shifts in lead aVR. Inter-observer agreement was analyzed using kappa statistics for the presence of aVR lead ST segment shifts. The patients were divided into two groups according to their Sx scores (≤ 22 and > 22). The mean age of the study population was 62.19 ± 12 years. Eighty-seven patients (37%) had complex coronary artery disease as defined by intermediate-high Sx scores, and 130 patients (55%) had ST-segment shifts in lead aVR. In multivariate logistic regression analysis, ST-segment elevation or depression ≥ 1 mm were independently associated with intermediate-high Sx scores. In patients with acute coronary syndrome, the presence of ST-segment elevation or depression ≥ 1 mm in lead aVR may indicate coronary complexity.
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