Non-ST-elevation acute coronary syndrome (NSTE ACS) includes unstable angina pectoris and non-ST-elevation myocardial infarction. The patient with NSTE ACS has a variable severity and prognosis. Early stratification of the patient is very important in reducing the incidence of sudden death and adverse events. The electrocardiogram (ECG) is a rapid and noninvasive diagnostic method, which exerts a critical role in the assessment of early risk stratification. Left main coronary artery (LMCA) is one of the major factors that affect the patient's prognosis. Atie found that most patients with LMCA lesions would appear to have ST-segment elevation (STE) in lead V1 and aVR and ST-segment depression in lead V3, V4, and V5 (especially in lead V4) when chest pain occurs (Atie et al., 1991).Lead aVR is often ignored in clinical practice. However, a number of studies have shown that the STE in lead aVR had a great significance on the prediction of vascular anticipation and clinical prognosis in patients with acute myocardial infarction (Nair & Glancy, 2002;Yamaji et al., 2001). As the research advanced, researchers commonly thought that STE in lead aVR suggested severe left main lesion or serious multivessel lesions (Li et al., 2009). But the results were not consistent among different stud-
Objective: Previous investigations yielded inconsistent results for diagnostic and prognostic predictive values of MicroRNAs (miRNAs) for acute myocardial infarction (AMI).Methods and results: We systematically searched on PubMed and Web of Science for articles explored association of miRNAs and AMI published from January 1989 to March 2019. For diagnostic studies, a summary of sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR), which indicated the accuracy of microRNAs in the differentiation of AMI and no AMI, were calculated from the true positive (TP), true negative (TN), false positive (FP), and false negative (FN) of each study. In addition, the summary receive-operating characteristics (SROC) curve was constructed to summarize the TP and FP rates. For follow-up study, we computed hazard ratios (HRs) and 95% confidence intervals (CIs) for individual clinical outcomes. The meta-analysis showed a sensitivity [0.72 (95%
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