Prognostic value of lead V1 ST elevation during acute inferior myocardial infarction
Cheuk-Kit Wong1, Wanzhen Gao, Ralph A Stewart
1Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
Circulation
|July 21, 2010
Summary
ST elevation in lead V(1) during acute inferior myocardial infarction indicates higher mortality risk, especially when persistent. This finding aids in identifying high-risk patients for better management.
Area of Science:
- Cardiology
- Electrocardiography
- Myocardial Infarction
Background:
- Lead V(1) ST elevation in acute inferior myocardial infarction (MI) can indicate right ventricular involvement or posterolateral MI.
- The prognostic significance of V(1) ST elevation may depend on concurrent V(3) ST changes.
Purpose of the Study:
- To investigate the prognostic significance of ST elevation in lead V(1) during acute inferior myocardial infarction.
- To determine if V(1) ST elevation predicts 30-day mortality, considering V(3) ST changes.
Main Methods:
- Analysis of 7967 patients from the HERO-2 trial with acute inferior MI.
- Electrocardiographic analysis of V(1) and V(3) ST levels, including baseline and post-fibrinolysis measurements.
- Statistical adjustment for V(3) ST levels, inferolateral ST elevation, and clinical factors to predict 30-day mortality.
Main Results:
- Baseline V(1) ST elevation as a continuous variable was associated with increased 30-day mortality (odds ratio 1.24 after adjustment).
- Each 0.5-mm increase in V(1) ST elevation correlated with a 25% rise in mortality.
- Persistent V(1) ST elevation (≥1 mm) 60 minutes post-fibrinolysis was linked to significantly higher mortality (10.8% vs. 5.5%).
Conclusions:
- ST elevation in lead V(1) is an independent predictor of higher mortality in acute inferior myocardial infarction.
- This ECG finding helps identify high-risk patients requiring closer monitoring and management.
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