Chest
Clinical Investigations CARDIOLOGYST-Segment Depression in Lead aVR: A Useful Predictor of Impaired Myocardial Reperfusion in Patients With Inferior Acute Myocardial Infarction
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Study Group
We enrolled 225 consecutive patients with inferior AMI (mean [± SD] age, 63 ± 11 years; 172 men and 53 women) who fulfilled the following criteria for study inclusion: (1) no history of myocardial infarction or of other types of heart disease except for coronary artery disease; (2) absence of conditions precluding the evaluation of ST-segment changes on the ECG (eg, left bundle branch block, right bundle branch block, and ventricular pacing); (3) achievement of successful recanalization
Patient Characteristics
Patients were divided into the following three groups according to ST-segment deviation in lead aVR on the ECG obtained at hospital admission: group A, 103 patients with no ST-segment depression; group B, 80 patients with ST-segment depression of ≤ 1.0 mm; and group C, 42 patients with ST-segment depression of > 1.0 mm (Fig 1). The baseline characteristics of the three groups are summarized in Table 1. There were no differences among the three groups in age, hemodynamics or Killip class on
Discussion
Several studies have suggested that even after successful recanalization of the infarct-related coronary artery, some patients do not have complete myocardial reperfusion and remain at risk for large infarcts and more frequent mortality.3, 4, 5 Therefore, the early and simple identification of such high-risk patients is required. Our study demonstrated that in patients with inferior AMIs, larger ST-segment depression in lead aVR was associated with impaired myocardial reperfusion.
Two studies1, 2
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