Document Detail

Electrocardiographic predictors of culprit artery in acute inferior ST elevation myocardial infarction.
MedLine Citation:
PMID:  20832813     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In acute inferior ST-segment elevation myocardial infarction (STEMI), multiple electrocardiographic algorithms have been proposed to predict the culprit artery. Our purpose is to review these and compare them to ST depression in lead aVR to predict culprit artery in inferior STEMI.
METHODS: In 106 patients with acute inferior STEMI who underwent emergent coronary angiography, we correlated electrocardiographic and angiographic findings pertaining to the culprit artery. We then reviewed the algorithms proposed by Fiol et al and Tierala et al, and applied them and our own from Kanei et al using ST depression in aVR for predicting the left circumflex artery (LCx) as the culprit, to the population. Finally, we compared the sensitivities and specificities of the respective algorithms for predicting the culprit artery.
RESULTS: The sensitivity and specificity of ST depression in lead aVR to predict LCx as the culprit were 53% and 86%, respectively, and 86% and 55%, respectively for predicting the right coronary artery (RCA) as the culprit. When their algorithms were applied to our population, the sensitivities and specificities of Fiol et al and Tierala et al were slightly higher.
CONCLUSION: Compared to other proposed algorithms, ST depression in aVR is a simple method with satisfactory sensitivity and specificity to predict the culprit artery in inferior STEMI.
Lori Vales; Yumiko Kanei; Paul Schweitzer
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Publication Detail:
Type:  Journal Article     Date:  2010-09-15
Journal Detail:
Title:  Journal of electrocardiology     Volume:  44     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2011 Jan-Feb
Date Detail:
Created Date:  2010-12-20     Completed Date:  2011-04-12     Revised Date:  2011-06-08    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2011 Elsevier Inc. All rights reserved.
Division of Cardiology, Department of Medicine, The Heart Institute at Beth Israel Medical Center, New York, NY 10003, USA.
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MeSH Terms
Coronary Stenosis / complications*,  diagnosis*
Diagnosis, Computer-Assisted / methods*
Electrocardiography / methods*
Middle Aged
Myocardial Infarction / diagnosis*,  etiology*
Reproducibility of Results
Sensitivity and Specificity
Comment In:
J Electrocardiol. 2011 May-Jun;44(3):393   [PMID:  21397909 ]

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

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