Clinical characteristics of patients with the de Winter electrocardiogram pattern

To explore the electrocardiogram manifestations and clinical characteristics of patients with the de Winter electrocardiogram pattern.

This retrospective study was performed on acute coronary syndrome (ACS), patients with culprit lesion in left anterior descending branch (LAD), who admitted to Yongchuan Hospital of Chongqing Medical University from August 2017 to October 2018. Patients were categorized into those with or without the de Winter electrocardiogram pattern. The characteristics of de Winter electrocardiogram were analyzed by the clinical data of the patients.

Among 230 patients with left anterior descending branch lesion, 14 (6%) had the de Winter electrocardiogram pattern. Compared with the control group, patients with de Winter electrocardiogram pattern were younger [(53.86±10.26) years old vs (67.20± 11.60) years old P<0.01], at higher LDL-C level [3.54(2.88, 4.20) mmol/L vs 2.61(2.48, 2.73) mmol/L, P=0.01], in lower classification degree of cardiac function [Killip I grade 12 cases (85.71%) vs 95 cases (43.98%), P=0.04], and in shorter time between onset and the first electrocardiogram [171.77(47.56, 295.97) min vs 501.92(405.12, 598.72) min, P=0.01]. Coronary angiography results indicated anterior descending or diagonal branch lesions.

The de Winter electrocardiogram pattern syndrome in patients with acute chest pain mostly indicates that the left anterior descending or the diagonal branch is subtotal or completely occluded, which is a special ST-segment elevation myocardial infarction equivalent and should attract the clinicians' extensive attention.