GIÁ TRỊ DỰ BÁO CỦA ST CHÊNH LÊN Ở CHUYỂN ĐẠO AVR ĐỐI VỚI BỆNH THÂN CHUNG ĐỘNG MẠCH VÀNH TRÁI HOẶC BỆNH BA NHÁNH MẠCH VÀNH TRÊN BỆNH NHÂN NHỒI MÁU CƠ TIM KHÔNG ST CHÊNH LÊN

Abstract

Objectives: Assess the prevalence and diagnostic accuracy of ST segment elevation in lead aVR for predicting left main or triple vessel coronary artery disease in patients with non-ST elevation myocardial infarction (NSTEMI). Methodology: Total 140 patients with NSTEMI having age 34-95 years were included in this case control study. The data on demographic details was collected. All patients underwent electrocardiography (ECG) and cardiac specific Troponin-I assessment. Patients were categorized as NSTEMI with or without ST-elevation in lead aVR. Coronary angiography was performed in all patients and angiographic results were noted. Results: Mean age of patients was 65,94 ± 11,95 years. There were 83 (59,29%) males and 57 (40,71%) female patients. 45 (32,14%) patients of NSTEMI had ST elevation in aVR (STEaVR). Left main (LM) or tripple vessel disease (3VD) was found in 32 (71,11%) patients with STEaVR. Sensitivity, specificity, positive predictive value and positive likelihood ratio of STEaVR for LM or 3VD were 45,07%, 81,16%, 71,11% and 2,39 respectively. STEaVR with ST depression in lateral leads has the highest positive predictive value, specificity and likelihood ratio (76,4%; 94,2%; 3,16 respectively). Conclusion: In NSTEMI patients, ST segment elevation in aVR is associated with the risk of left main or triple vessel coronary artery disease is 32,14%. ST segment elevation in aVR with ST depression in lateral leads may support the use these findings in predicting severe coronary artery disease in patients diagnosed with an NSTEMI.