Cargando…

Chicken or the egg: ST elevation in lead aVR or SYNTA X score

BACKGROUND: ST-segment elevation in lead aVR (STEaVR) anticipates left main and/or three-vessel disease (LM/3VD) in patients with acute coronary syndromes. STEaVR is generally reciprocal to and accompanied by ST-segment depression (STD) in the precordial leads. SYNTAX score (SS) is an angiographic s...

Descripción completa

Detalles Bibliográficos
Autor principal: Cerit, Levent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Clinics Cardive Publishing 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488054/
https://www.ncbi.nlm.nih.gov/pubmed/27276224
http://dx.doi.org/10.5830/CVJA-2016-062
_version_ 1783246581424717824
author Cerit, Levent
author_facet Cerit, Levent
author_sort Cerit, Levent
collection PubMed
description BACKGROUND: ST-segment elevation in lead aVR (STEaVR) anticipates left main and/or three-vessel disease (LM/3VD) in patients with acute coronary syndromes. STEaVR is generally reciprocal to and accompanied by ST-segment depression (STD) in the precordial leads. SYNTAX score (SS) is an angiographic scoring system and is widely used to evaluate the severity and complexity of coronary artery disease. The purpose of our study was to assess the relationship between STEaVR and SS. METHODS: We performed a retrospective analysis of 117 patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Electrocardiograms at presentation were reviewed, especially for ST-segment elevation of ≥ 0.05 mV in lead aVR and STD of ≥ 0.05 mV in more than two contiguous leads. All lesions causing ≥ 50% stenosis in a coronary artery with a diameter of ≥ 1.5 mm were included in the SS calculation. SS was divided into two groups: ≥ 23: high, < 23: low. RESULTS: Among the 117 patients, 80 (68.4%) had STEaVR and 37 (31.6%) did not. Patients with STEaVR had a higher SS and higher rate of LM/3VD (85 vs 67.6%, p < 0.001; 86.2 vs 72.9%, p = 0.03, respectively) than those without STEaVR. On multivariate analysis, STEaVR [odds ratio (OR) 1.85; 95% confidence interval (CI): 1.20–3.97, p = 0.03] and STD in leads V(1)–V(4) (OR 2.14; 95% CI: 1.46–4.23, p = 0.002) were independent predictors of a high SS. CONCLUSION: This study demonstrated that STEaVR was an independent predictor of a high SS.
format Online
Article
Text
id pubmed-5488054
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher Clinics Cardive Publishing
record_format MEDLINE/PubMed
spelling pubmed-54880542017-07-13 Chicken or the egg: ST elevation in lead aVR or SYNTA X score Cerit, Levent Cardiovasc J Afr Cardiovascular Topics BACKGROUND: ST-segment elevation in lead aVR (STEaVR) anticipates left main and/or three-vessel disease (LM/3VD) in patients with acute coronary syndromes. STEaVR is generally reciprocal to and accompanied by ST-segment depression (STD) in the precordial leads. SYNTAX score (SS) is an angiographic scoring system and is widely used to evaluate the severity and complexity of coronary artery disease. The purpose of our study was to assess the relationship between STEaVR and SS. METHODS: We performed a retrospective analysis of 117 patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Electrocardiograms at presentation were reviewed, especially for ST-segment elevation of ≥ 0.05 mV in lead aVR and STD of ≥ 0.05 mV in more than two contiguous leads. All lesions causing ≥ 50% stenosis in a coronary artery with a diameter of ≥ 1.5 mm were included in the SS calculation. SS was divided into two groups: ≥ 23: high, < 23: low. RESULTS: Among the 117 patients, 80 (68.4%) had STEaVR and 37 (31.6%) did not. Patients with STEaVR had a higher SS and higher rate of LM/3VD (85 vs 67.6%, p < 0.001; 86.2 vs 72.9%, p = 0.03, respectively) than those without STEaVR. On multivariate analysis, STEaVR [odds ratio (OR) 1.85; 95% confidence interval (CI): 1.20–3.97, p = 0.03] and STD in leads V(1)–V(4) (OR 2.14; 95% CI: 1.46–4.23, p = 0.002) were independent predictors of a high SS. CONCLUSION: This study demonstrated that STEaVR was an independent predictor of a high SS. Clinics Cardive Publishing 2017 /pmc/articles/PMC5488054/ /pubmed/27276224 http://dx.doi.org/10.5830/CVJA-2016-062 Text en Copyright © 2015 Clinics Cardive Publishing http://creativecommons.org/licenses/by/2.5/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Cardiovascular Topics
Cerit, Levent
Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title_full Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title_fullStr Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title_full_unstemmed Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title_short Chicken or the egg: ST elevation in lead aVR or SYNTA X score
title_sort chicken or the egg: st elevation in lead avr or synta x score
topic Cardiovascular Topics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5488054/
https://www.ncbi.nlm.nih.gov/pubmed/27276224
http://dx.doi.org/10.5830/CVJA-2016-062
work_keys_str_mv AT ceritlevent chickenortheeggstelevationinleadavrorsyntaxscore