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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment

Masami Kosuge1, Kazuo Kimura, Toshiyuki Ishikawa

  • 1The Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.

The American Journal of Cardiology
|May 21, 2005
PubMed

Insights

ST-segment elevation in lead aVR (>0.5 mm) and positive troponin T are early, noninvasive predictors of left main or 3-vessel disease in acute coronary syndromes. These findings aid in identifying high-risk patients early.

Area of Science:

  • Cardiology
  • Diagnostic Medicine
  • Emergency Medicine

Background:

  • Left main (LM) or 3-vessel disease (3-VD) are critical coronary artery pathologies.
  • Early identification of LM/3-VD in acute coronary syndromes (ACS) is crucial for timely intervention.
  • Noninvasive predictors for LM/3-VD in non-ST-segment elevation ACS (NSTEME-ACS) are needed.

Purpose of the Study:

  • To identify simple, noninvasive early predictors of LM/3-VD in patients with NSTEME-ACS.
  • To evaluate the predictive value of clinical variables on admission for LM/3-VD.

Main Methods:

  • Retrospective study of 310 NSTEME-ACS patients.
  • Analysis of clinical variables on admission.
  • Univariate and multivariate logistic regression to identify predictors of LM/3-VD.

Main Results:

  • ST-segment elevation in lead aVR of ≥0.5 mm was the strongest predictor (OR 19.7, p<0.001).
  • Positive troponin T was also a significant predictor (OR 3.08, p=0.048).
  • ST-segment elevation in lead aVR demonstrated high sensitivity (78%) and specificity (86%) for LM/3-VD.

Conclusions:

  • ST-segment elevation in lead aVR (≥0.5 mm) and positive troponin T are valuable early predictors of LM/3-VD in NSTEME-ACS.
  • ST-segment elevation in lead aVR is a particularly strong and useful predictor.
  • These findings can aid in risk stratification and management decisions for NSTEME-ACS patients.

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