Inferior ST-Segment Elevation Can Predict In-Hospital Mortality in Patients with Anterior Myocardial Infarction
Xiaojuan Fan1, Shun Wang1, Ping Liu1
1Department of Cardiovascular Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi, China.
Insights
Electrocardiogram (ECG) findings in anterior myocardial infarction (MI) with ventricular septal rupture (VSR) are rarely studied. Inferior ST-segment elevation (STE) on ECG predicts higher in-hospital mortality in these complex MI patients.
Area of Science:
- Cardiology
- Internal Medicine
- Medical Diagnostics
Background:
- Anterior wall myocardial infarction (MI) complicated by ventricular septal rupture (VSR) presents a rare but severe clinical challenge.
- Electrocardiogram (ECG) findings in this specific patient cohort have not been extensively investigated.
Purpose of the Study:
- To investigate the predictive value of specific ECG findings for in-hospital mortality in patients with anterior MI and VSR.
- To identify key electrocardiographic markers associated with adverse outcomes in this high-risk population.
Main Methods:
- A single-center retrospective study was conducted over ten years.
- ECG data, including ST-segment elevation (STE) in inferior leads and new-onset right bundle branch block (RBBB), were analyzed.
- Multivariate logistic regression was used to assess the independent predictors of in-hospital mortality.
Main Results:
- Of 85 patients, 76.5% died in-hospital. Inferior STE was present in 41.2% of patients and was significantly associated with mortality (P = 0.005).
- New-onset RBBB was observed in 29.4% of patients, but did not reach statistical significance for predicting mortality (P = 0.103).
- Multivariate analysis identified inferior STE as an independent predictor of in-hospital death (OR: 14.488, P = 0.014).
Conclusions:
- Inferior ST-segment elevation on ECG is a significant predictor of in-hospital mortality in patients experiencing anterior MI complicated by VSR.
- These ECG findings can aid in risk stratification and early identification of high-risk patients requiring intensive management.
Background:
Electrocardiogram (ECG) findings in patients with anterior wall myocardial infarction (MI) complicated by ventricular septal rupture (VSR) have rarely been studied.
Methods:
We conducted a single-center retrospective study among patients with anterior MI complicated by VSR over the past ten years. The presence of ST-segment elevation (STE) in inferior leads and new onset of complete right bundle branch block (RBBB) on ECG were studied for the prediction of in-hospital mortality.
Results:
Among the 85 patients enrolled, 45 (52.9%) were male, with a median age of 70 years. Sixty-five patients (76.5%) died in the hospital, and the remaining 20 patients (23.5%) had improved conditions and were discharged. Inferior STE was present in 35 patients (41.2%), including 32 patients in the death group and 3 patients in the survival group (P = 0.005). New-onset RBBB was present in 25 patients (29.4%), with 22 patients in the death group and 3 patients in the survival group (P = 0.103). Multivariate logistic regression showed that inferior STE was an independent predictor of in-hospital death in patients with anterior MI and VSR (OR: 14.488; 95% CI: 1.708-122.887; P = 0.014).
Conclusions:
In patients with anterior MI complicated by VSR, inferior STE was associated with a higher risk of in-hospital mortality.
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