Eyyup Tusun1, Mahmut Uluganyan2, Murat Ugur1, Gurkan Karaca3, Faizel Osman4, Bayram Koroglu1, Ahmet Murat1, Ahmet Ekmekci1, Hüseyin Uyarel5, Osman Sahin1, Mehmet Eren1, Osman Bolca1. 1. Clinic of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Center Training and Research Hospital, Istanbul, Turkey. 2. Clinic of Cardiology, Kadirli Government Hospital, Osmaniye, Turkey. 3. Clinic of Cardiology, Osmancik Government Hospital, Corum, Turkey. 4. Department of Cardiology, University Hospital Coventry, Coventry, United Kingdom. 5. Clinic of Cardiology, Bezmialem University Hospital, Istanbul, Turkey.
Abstract
BACKGROUND: ST segment elevation of chest lead V4 R is associated with worse prognosis in acute inferior ST-elevation myocardial infarction (STEMI). This study tried to determine the relationship between ST elevation in the right precordial lead V4 R and acute anterior STEMI. METHODS: Prospective study of 144 consecutive anterior STEMI patients: all had 15-lead ECG recordings (12 conventional leads and V3 R-V5 R) obtained. Patients were classified into two groups on the basis of presence (Group I, 50 patients) or absence (Group II, 94 patients) of ST-segment elevation ≥0.5 mm in lead V4 R. RESULTS: Multivessel involvement was significantly higher in Group I compared with Group II (54% and 23% respectively, P < 0.001). Major adverse cardiac events and in-hospital mortality was also significantly higher for those in Group I (P < 0.02 for both). A significant correlation was found between in-hospital mortality and those in Group I (P = 0.03, OR: 6.27, CI: 1.22-32.3). There was an independent relationship between in-hospital mortality and V4 R-ST elevation (P = 0.03, OR: 11.64, CI: 1.3-27.4). CONCLUSION: ST segment elevation in chest lead V4 R is associated with multivessel disease and increased in-hospital mortality in patients with anterior STEMI that had undergone primary percutaneous coronary intervention to the left anterior descending artery.
BACKGROUND: ST segment elevation of chest lead V4 R is associated with worse prognosis in acute inferior ST-elevation myocardial infarction (STEMI). This study tried to determine the relationship between ST elevation in the right precordial lead V4 R and acute anterior STEMI. METHODS: Prospective study of 144 consecutive anterior STEMI patients: all had 15-lead ECG recordings (12 conventional leads and V3 R-V5 R) obtained. Patients were classified into two groups on the basis of presence (Group I, 50 patients) or absence (Group II, 94 patients) of ST-segment elevation ≥0.5 mm in lead V4 R. RESULTS: Multivessel involvement was significantly higher in Group I compared with Group II (54% and 23% respectively, P < 0.001). Major adverse cardiac events and in-hospital mortality was also significantly higher for those in Group I (P < 0.02 for both). A significant correlation was found between in-hospital mortality and those in Group I (P = 0.03, OR: 6.27, CI: 1.22-32.3). There was an independent relationship between in-hospital mortality and V4 R-ST elevation (P = 0.03, OR: 11.64, CI: 1.3-27.4). CONCLUSION: ST segment elevation in chest lead V4 R is associated with multivessel disease and increased in-hospital mortality in patients with anterior STEMI that had undergone primary percutaneous coronary intervention to the left anterior descending artery.
Authors: Andreas P Michaelides; Christos A Fourlas; George K Andrikopoulos; Polychronis E Dilaveris; Athanasios Kartalis; Maria-Niki K Aigyptiadou; Zoi D Psomadaki; Christodoulos I Stefanadis Journal: Coron Artery Dis Date: 2006-03 Impact factor: 1.439
Authors: T Ben-Gal; S Sclarovsky; I Herz; B Strasberg; B Zlotikamien; J Sulkes; Y Birnbaum; G S Wagner; A Sagie Journal: J Am Coll Cardiol Date: 1997-03-01 Impact factor: 24.094
Authors: B E Jaski; J D Cohen; J Trausch; D G Marsh; G R Bail; P A Overlie; E W Skowronski; S C Smith Journal: Am Heart J Date: 1992-12 Impact factor: 4.749
Authors: Muhammed Keskin; Ahmet Okan Uzun; Edibe Betül Börklü; Mert İlker Hayıroğlu; Ceyhan Türkkan; Ahmet İlker Tekkeşin; Ömer Kozan Journal: Ann Noninvasive Electrocardiol Date: 2017-10-14 Impact factor: 1.468