Relationship between ST-Segment Shifts in Lead aVR and Coronary Complexity in Patients with Acute Coronary Syndrome
Adem Adar1, Orhan Onalan1, Fahri Cakan1
1Department of Cardiology, Karabuk University, Faculty of Medicine, Karabuk, Turkey.
Insights
ST-segment shifts in lead aVR are linked to complex coronary artery disease in acute coronary syndrome patients. This finding may help identify patients needing further investigation for coronary complexity.
Area of Science:
- Cardiology
- Diagnostic Electrocardiography
Background:
- ST-segment shifts in lead aVR correlate with coronary atherosclerosis.
- Limited data exists on the association between lead aVR ST-segment shifts and coronary complexity.
Purpose of the Study:
- To investigate the relationship between ST-segment shifts in lead aVR and coronary complexity in acute coronary syndrome (ACS) patients.
Main Methods:
- Prospective observational study of 236 ACS patients undergoing coronary angiography.
- Electrocardiograms analyzed for ST-segment shifts in lead aVR.
- Patients categorized by Sx scores (≤ 22 and > 22) to define coronary complexity.
Main Results:
- 55% of patients exhibited ST-segment shifts in lead aVR.
- 37% of patients had complex coronary artery disease (intermediate-high Sx scores).
- ST-segment elevation or depression (≥ 1 mm) in lead aVR independently predicted intermediate-high Sx scores.
Conclusions:
- ST-segment elevation or depression ≥ 1 mm in lead aVR may serve as an indicator of coronary complexity in ACS patients.
Background:
ST-segment shifts in lead aVR are associated with increased coronary atherosclerosis. However, there is insufficient data about the relationship between ST-segment shifts in lead aVR and coronary complexity. The aim of this study was to investigate this relationship.
Methods:
This prospective, observational study included 236 patients with acute coronary syndrome who underwent coronary angiography. Electrocardiograms on presentation were reviewed in terms of ST-segment shifts in lead aVR. Inter-observer agreement was analyzed using kappa statistics for the presence of aVR lead ST segment shifts. The patients were divided into two groups according to their Sx scores (≤ 22 and > 22).
Results:
The mean age of the study population was 62.19 ± 12 years. Eighty-seven patients (37%) had complex coronary artery disease as defined by intermediate-high Sx scores, and 130 patients (55%) had ST-segment shifts in lead aVR. In multivariate logistic regression analysis, ST-segment elevation or depression ≥ 1 mm were independently associated with intermediate-high Sx scores.
Conclusions:
In patients with acute coronary syndrome, the presence of ST-segment elevation or depression ≥ 1 mm in lead aVR may indicate coronary complexity.
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