ST-segment deviation score in the risk prediction of patients with suspected acute myocardial infarction

Abstract

(ECG) leads, combined with ST elevation in aVR and V1, is associated with a 75% predictive accuracy of three-vessel disease (3VD) or left main (LM) stenosis. However, our clinical impression is that in our patient population, most of the ECGs showing such a pattern are taken from patients with left ventricular hypertrophy with repolarization changes or from patients with cardiomyopathy. Methods:Wecollected 152ECGs showing this particular pattern from the ones sent for routine reading at the St. Luke's Episcopal Hospital ECG laboratory. Patients with left bundle branch block and QRS duration of ≥ 130 ms, ventricular rhythm or ventricular paced rhythm were excluded. Demographic data, the indication for the ECG, presence of elevated cardiac markers, performance of coronary angiography (if so, number of diseases vessels and presence of left main stenosis≥ 50%), performance of revascularization (PCI or CABG) following the ECGand the existence of previous ECG (N 24 h)with the same pattern or without this pattern were obtained. Results: Out of 152 patients, 11 (7.2%) had insufficient data for the study. Out of 141 patients with data, 60 (42.6%) underwent coronary cath (XA) and 81 (57.4%) did not.