The prognostic significance of early and late right precordial lead (V<sub>4</sub>R) ST-segment elevation in patients with acute anterior myocardial infarction
ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, cilt.23, sa.2, 2018 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 23 Sayı: 2
- Basım Tarihi: 2018
- Doi Numarası: 10.1111/anec.12513
- Dergi Adı: ANNALS OF NONINVASIVE ELECTROCARDIOLOGY
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
- Acıbadem Mehmet Ali Aydınlar Üniversitesi Adresli: Hayır
Özet
BackgroundThe predictive significance of ST-segment elevation (STE) in lead V4R in patients with anterior ST-segment elevation myocardial infarction (STEMI) has not been well-understood. In this study, we evaluated the prognostic value of early and late STE in lead V4R in patients with anterior STEMI. MethodsA total 451 patients with anterior STEMI who treated with primary percutaneous coronary intervention (PPCI) were prospectively enrolled in this study. All patients were classified according to presence of STE (>1mm) in lead V4R at admission and/or 60min after PPCI. Based on this classification, all patients were divided into three subgroups as no V4R STE (Group 1), early but not late V4R STE (Group 2) and late V4R STE (Group 3). ResultsIn-hospital mortality had higher rates at group 2 and 3 and that had 2.1 and 4.1-times higher mortality than group 1. Late V4R STE remained as an independent risk factor for cardiogenic shock (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.9-4.3; p<.001) and in-hospital mortality (OR 2.3; 95% CI 1.8-4.1; p<.001). The 12-month overall survival for group 1, 2, and 3 were 91.1%, 82.4%, and 71.4% respectively. However, the long-term mortality also had the higher rate at group 3; late V4R STE did not remain as an independent risk factor for long-term mortality (OR 1.5; 95% CI 0.8-4.1; p: .159). ConclusionLate V4R STE in patients with anterior STEMI is strongly associated with poor prognosis. The record of late V4R in patients with anterior STEMI has an important prognostic value.