Diagnostic performance of electrocardiography in the assessment of significant coronary artery disease and its anatomical size in comparison with coronary angiography

BACKGROUND: Current study addressed the predictive value of 12-lead electrocardiogram (ECG) in patients with suspected coronary artery disease (CAD). METHODS: Four hundred consecutive patients with new onset of chest pain were studied. A resting standard 12-lead ECG was recorded and all patients underwent coronary angiography. RESULTS: ECG correctly detected significant stenosis in 176 out of 400 patients with an overall sensitivity per patient of 51.5% and specificity per patient of 66.1%. Based on artery analysis, ECG had the highest and lowest sensitivity for the detection of involvement in LAD (37.3%) and RCA (25.8%), respectively. ROC curve analysis showed that ECG changes were not good indicators of coronary arteries involvement with areas under the ROC curves 0.586 (for LAD artery), 0.524 (for RCA artery) and 0.530 (for LCX artery). CONCLUSIONS: ECG has low partial sensitivity and specificity for predicting coronary artery stenosis with accuracy ranged 58.5 to 62.0 percent based on coronary artery analysis.