The accuracy of distribution of non-ST elevation electrocardiographic changes in localising the culprit vessel in non-ST elevation myocardial infarction.

coronary angiogram culprit vessel non-ST elevation ischaemic changes non-ST segment elevation myocardial infarction

Journal

Archives of medical sciences. Atherosclerotic diseases
ISSN: 2451-0629
Titre abrégé: Arch Med Sci Atheroscler Dis
Pays: Poland
ID NLM: 101701205

Informations de publication

Date de publication:
2020
Historique:
received: 12 08 2020
accepted: 16 08 2020
entrez: 11 12 2020
pubmed: 12 12 2020
medline: 12 12 2020
Statut: epublish

Résumé

ST-segment elevation distribution on electrocardiogram (ECG) in patients presenting with ST-elevation myocardial infarction (STEMI) accurately localises the culprit vessel. However, the utility of the ECG changes in localising the coronary culprit territory in the setting of non-ST segment elevation myocardial infarction (NSTEMI) is not well established. This study included patients presenting with NSTEMI, who had dynamic non-ST elevation ischaemic changes in one or more ECG leads and underwent percutaneous coronary intervention (PCI) in a single vessel between October 2011 and November 2017 in a single university hospital institution. The accuracy, sensitivity, and specificity of the distribution of ECG changes in localising the culprit vessel were calculated. There was a total of 82 patients included in this study, who received PCI to the left anterior descending (LAD), right coronary artery (RCA), and left circumflex (LCX), in 43.9%, 24.4%, and 31.7%, respectively; 51% were male. In this cohort, sensitivity of ECG in localising single-culprit-vessel NSTEMI was 41.5%. The overall accuracy of ECG changes was 50.0%, 72.0%, and 70.0% in LAD, RCA, and LCX distribution, respectively. The sensitivity and specificity were 72.2% and 32.6% in LAD distribution, 20% and 88.7% in RCA distribution, and 15.4% and 82.1% in LCX distributions, respectively. Ischaemic non-ST elevation ECG changes had modest accuracy in localising the culprit vessel in patients with PCI-treated NSTEMI. These changes were more sensitive in LAD distribution and more specific in RCA and LCX distributions.

Identifiants

pubmed: 33305060
doi: 10.5114/amsad.2020.98924
pii: 41762
pmc: PMC7717448
doi:

Types de publication

Journal Article

Langues

eng

Pagination

e226-e229

Informations de copyright

Copyright: © 2020 Termedia & Banach.

Déclaration de conflit d'intérêts

The authors declare no conflict of interest.

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Auteurs

Kristina Gifft (K)

Department of General Medicine, University of Missouri Health Care, Columbia, MO, USA.

Rugheed Ghadban (R)

Division of Cardiology, Washington University, St Louis, MO, USA.

Nina Assefa (N)

Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA.

Zachary Luebbering (Z)

Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, MO, USA.

Haytham Allaham (H)

Division of Cardiology, University of Maryland, Baltimore, MD, USA.

Tariq Enezate (T)

Division of Cardiology, University of California Log Angeles-Harbor Medical Center, Los Angeles, CA, USA.

Classifications MeSH