Chicken or the egg: ST elevation in lead aVR or SYNTAX score
1Near East University Hospital, Nicosia, Cyprus.
Cardiovascular Journal of Africa
|June 9, 2016
Summary
ST-segment elevation in lead aVR (STEaVR) is a significant indicator of severe coronary artery disease. This finding helps identify patients who may benefit from further cardiac assessment and intervention.
Area of Science:
- Cardiology
- Clinical Electrocardiography
- Interventional Cardiology
Background:
- ST-segment elevation in lead aVR (STEaVR) is associated with left main and/or three-vessel coronary artery disease (LM/3VD) in acute coronary syndromes.
- STEaVR often presents reciprocally with ST-segment depression in precordial leads.
- The SYNTAX score (SS) is a validated tool for assessing coronary artery disease severity and complexity.
Purpose of the Study:
- To investigate the correlation between STEaVR and the SYNTAX score in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS).
Main Methods:
- Retrospective analysis of 117 NSTEACS patients.
- Electrocardiograms were analyzed for STEaVR (≥ 0.05 mV in lead aVR) and ST-segment depression (STD) in contiguous precordial leads (≥ 0.05 mV).
- SYNTAX score was calculated, categorizing patients into high (≥ 23) and low (< 23) score groups.
Main Results:
- 80 patients (68.4%) exhibited STEaVR.
- Patients with STEaVR demonstrated significantly higher SS and a greater prevalence of LM/3VD compared to those without STEaVR.
- Multivariate analysis confirmed STEaVR and precordial STD as independent predictors of a high SS.
Conclusions:
- STEaVR is an independent predictor of high SYNTAX scores in NSTEACS patients.
- The presence of STEaVR warrants careful evaluation for complex coronary artery disease.
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