Document Detail


Designing prehospital ECG systems for acute coronary syndromes. Lessons learned from clinical trials involving 12-lead ST-segment monitoring.
MedLine Citation:
PMID:  16226097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Clinical trials in prehospital electrocardiography have focused primarily on ST elevation myocardial infarction (STEMI). The aims of this study were to determine, in patients presenting to the emergency department with acute coronary syndrome (ACS), the (1) relative frequency of various ACS types and (2) sensitivity of conventional ST-T criteria for diagnosing ischemia in non-STEMI or unstable angina. METHODS: A secondary analysis was conducted using data from prospective trials involving 12-lead ST monitoring. RESULTS: Of 968 patients with ACS, 120 (12%) were STEMI, 289 (30%) were non-STEMI, and 559 (58%) were unstable angina. Conventional electrocardiogram (ECG) criteria were insensitive (sensitivity, 20%) for detecting ischemia in patients with non-STEMI or unstable angina. There was no ischemia on the initial ECG in 85 patients who had subsequent events with ST monitoring. CONCLUSION: Non-STEMI and unstable angina are the most prevalent types of ACS. The initial ECG is insensitive for detecting ischemia in this population. Transient myocardial ischemia detected with ST monitoring commonly occurs in patients without ischemia on the initial ECG. ST monitoring should be considered in designing prehospital ECG systems.
Authors:
Barbara J Drew; Michele M Pelter; Eunyoung Lee; Jessica Zegre; Daniel Schindler; Kirsten E Fleischmann
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  38     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-10-17     Completed Date:  2006-04-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  180-5     Citation Subset:  IM    
Affiliation:
Department of Physiological Nursing, University of California, San Francisco, CA 94143, USA. barbara.drew@nursing.ucsf.edu
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Clinical Trials as Topic
Coronary Disease / diagnosis*,  physiopathology
Electrocardiography*
Emergency Medical Services / methods*
Humans
Myocardial Ischemia / diagnosis
Prospective Studies
San Francisco
Sensitivity and Specificity
Syndrome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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