Proximal LAD and LCx occlusion usually associated with poorer clinical outcome in ACS. Hence, a rapid and efficient tool is needed to identify those conditions and initiate reperfusion at the earliest. We studied ECG features in relation to angiographic findings to identify the culprit artery in AWMI and IWMI.
This study aims to compare and correlate the ECG features with angiographic findings in STEMI.
In this observational study, 73 AWMI and 59 IWMI patients having their completed ECG and coronary angiography reports were included. The required data were obtained by a pretested proforma. The ECG was analysed to predict the culprit vessel, and correlate it with angiographic finding.
Among 132 patients, 71.2% were male and mean age was 60.95±11.52; whereas diabetes (35.6%) was the commonest comorbidity. The criteria with maximum specificity in prediction proximal LAD lesion in AWMI are RBBB and ST↓in inferior leads; whereas ST↓in inferior leads and ST↑V1>2.5mm had high sensitivity for proximal LAD lesion. ST↓lead I, ST↑III >II and ST↓aVL were highly specific in differentiating diseased RCA from LCx in IWMI. In identifying proximal RCA occlusion, LCx in IWMI. In identifying proximal RCA occlusion,ST↓V3/ST↑<0.5 nd ST↑V1 were the most sensitive and the most specific criteria respectively. On the other hand, ST↑lead I and ST↑II>III had the highest specificity and sensitivity respectively in locating LCx lesion. Conclusion: Those criteria help in predicting the culprit artery; but they cannot replace the invasive procedure in confirming culprit vessel.
Those criteria help in predicting the culprit artery; but they cannot replace the invasive procedure in confirming culprit vessel.