Document Detail

Clinical implications of precordial ST-segment elevation in acute inferoposterior myocardial infarction caused by proximal right coronary artery occlusion.
MedLine Citation:
PMID:  17674377     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The clinical significance of inferior wall acute myocardial infarction (MI) with combined ST-segment elevation in both anterior and inferior leads, compared with inferior leads alone, is unknown. HYPOTHESIS: Despite having more leads with precordial ST-segment elevation, these patients may have a better outcome due to less posterior involvement, which tends to drag down the precordial ST-segment. METHODS: A total of 158 postinferior MI patients with documented proximal right coronary artery occlusion were retrospectively studied. They were divided into three subgroups according to the magnitude of concurrent ST-segment deviation in lead V2: Group A (n = 19) had ST-segment elevation >/= 2.0 mm; Group B (n = 74) had ST-segment lay between + 2.0 mm and - 2.0 mm; and Group C (n = 65) had ST-segment depression >/= 2.0 mm. The clinical and electrocardiographic characteristics were then compared among these threes subgroups. RESULTS: The baseline demography, prevalence of risk factors, and treatment received were of no difference among the subgroups. However, Group A patients had significantly lower peak creatinine phosphokinase level and more preserved left ventricular function than Group B and C. Moreover, they had lower total sum of inferior ST-segment magnitude, less ST-segment depression in V4-6, and more ST-segment elevation in V(4R) than Group C. Group C patients had highest in-hospital and one-year mortality although it did not reach statistical significance. CONCLUSIONS: Precordial ST-segment elevation in inferior wall acute MI was associated with smaller infarct size and better left ventricular function, probably secondary to occlusion of a less dominant RCA, which did not result in a significant posterior infarction.
Man-Hong Jim; Annie On-On Chan; Chun-Pong Wong; Kai-Hang Yiu; Raymond Miu; Stephen Wai-Luen Lee; Chu-Pak Lau
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical cardiology     Volume:  30     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-08-09     Completed Date:  2007-09-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  331-5     Citation Subset:  IM    
Cardiac Medical Unit, Grantham Hospital, Hong Kong.
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MeSH Terms
Coronary Stenosis / complications*,  physiopathology
Follow-Up Studies
Middle Aged
Myocardial Infarction / etiology,  physiopathology*
Retrospective Studies
Severity of Illness Index
Stroke Volume / physiology
Ventricular Function, Left / physiology

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