Value of ST-Segment Elevation in Lead aVR for Predicting Severe Left Main or 3-Vessel Disease

Kosuge, Masami; Kimura, Kazuo

doi:10.1016/j.amjmed.2015.12.016

Cited by 1 publication

(1 citation statement)

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“…Researches have reported that ST-segment elevation (STE) in aVR is correlated with higher morbidity due to left main and/or 3-vessel disease (LM/3-VD), poor prognosis for large infarcts, and low left ventricular ejection fraction (LVEF) in ACS. [3,4] Determination of Global Registry of Acute Coronary Events (GRACE) risk score has proven to be an accurate method of predicting poor prognosis in patients with ACS and has also been used to estimate the probability of all-cause mortality from hospitalization to 1-year following discharge. [5][6][7] Both STE in aVR and high GRACE score are known to have prognostic value.…”

Section: Introductionmentioning

confidence: 99%

Predictive value of ST-segment deviation in aVR in patients suffering from acute coronary syndrome: A retrospective cohort study

Hong

Zeng

2022

Medicine

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Changes in the ST-segment in aVR of electrocardiogram have been used to predict the morbidity of left main and/or 3-vessel disease (LM/3-VD) in patients with acute coronary syndrome (ACS). However, the association with patient prognosis has rarely been reported.A total of 274 patients diagnosed with ACS were retrospectively evaluated following allocation into 1 of 3 groups: the ST-segment elevation (STE) group ≥ 0.05 mV, ST-segment depression (STD) group ≥ 0.05 mV, and the Isoelectric group in aVR. A comparison of clinical characteristics, coronary angiography results, major adverse cardiovascular events (MACE), and GRACE risk score was made.Patients in the STE and STD groups were older and had a lower LVEF, a greater number of MACE and higher GRACE risk score, compared with patients in the isoelectric group. Patients in the STE group had significantly greater morbidity due to LM/3-VD than did the non-STE groups. In addition, as the amplitude of STE in aVR increased, the number of MACE, GRACE risk score, and the incidence of LM/3-VD increased. Furthermore, after adjusting for other clinical factors, multivariate statistical results indicated that STE ≥ 0.05 mV in aVR was the only predictor of LM/3-VD, whereas STD ≥ 0.05 mV was not. It was found that STE or STD ≥ 0.05 mV in aVR was an independent predictor of MACE. STE ≥ 0.05 mV in aVR is associated with LM/3-VD. Furthermore, ST-segment deviation in aVR may have prognostic value of MACE and associated with higher GRACE risk scores in patients with ACS.

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