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Electrocardiographic presentation of left main disease in patients undergoing urgent or emergent coronary artery bypass grafting.
MedLine Citation:
PMID:  21474892     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: Widespread ST-segment depression with inverted T waves maximally in leads V4-V5 (ie, the global ischemia electrocardiogram [ECG] pattern) is a marker of adverse outcome in patients with non-ST-segment elevation acute coronary syndrome (ACS), perhaps because this pattern is indicative of left main stem stenosis. However, the prognostic value of this ECG pattern has not yet been established. Objective: We studied the predictive value of a prespecified ECG pattern in patients who underwent urgent or emergent coronary artery bypass grafting (CABG). Methods: We studied the sensitivity, specificity, and predictive values for the global ischemia ECG to predict angiographic left main coronary artery disease. Patients with a 12-lead ECG recorded during anginal symptoms before CABG were included. Results: The global ischemia ECG pattern was found in 61 (76%) of 80 patients with and 12 (19%) of 65 patients without left main disease. The sensitivity, specificity, and positive and negative predictive values for left main coronary artery disease in patients with the global ischemia ECG pattern were 76%, 81%, 84%, and 74%, respectively. In multivariate analysis, the global ischemia ECG pattern was strongly associated with angiographic left main coronary artery disease after adjusting for age, gender, diabetes, hypertension, and smoking (hazard ratio, 16.0; 95% confidence interval, 6.5-39.5; P < 0.001). Conclusion: The global ischemia ECG pattern was strongly associated with angiographic left main coronary artery disease in patients who underwent urgent or emergent CABG.
Authors:
Kjell Nikus; Otso Järvinen; Samuel Sclarovsky; Heini Huhtala; Matti Tarkka; Markku Eskola
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Postgraduate medicine     Volume:  123     ISSN:  1941-9260     ISO Abbreviation:  Postgrad Med     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-04-08     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401147     Medline TA:  Postgrad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  AIM; IM    
Affiliation:
Heart Center, Tampee University Hospital, Tampere, Finland. kjell.nikus@sydankeskus.fi.
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