ArticleCardiovascular diagnosis and therapy2016
Anatomic distribution of culprit lesions in patients with non-ST-segment elevation myocardial infarction and normal ECG.
Article in Cardiovascular diagnosis and therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 17 citations in OpenAlex.
- Clinical Implications of High-Sensitivity Troponin Elevation Levels in Non-ST-Segment Elevation Myocardial Infarction Patients: Beyond Diagnostics.Diagnostics (Basel, Switzerland) · 2024Article
- Comparing coronary artery cross-sectional area among asymptomatic South Asian, White, and Black participants: the MASALA and CARDIA studies.BMC cardiovascular disorders · 2024Article
- Characteristics of Patients With Acute Coronary Syndrome and Normal Electrocardiogram.Medical archives (Sarajevo, Bosnia and Herzegovina) · 2024Article
- NSTEMI with total left circumflex occlusion: how the N-wave might help (case report).Oxford medical case reports · 2022Article
- Review of cardiovascular imaging in the Journal of Nuclear Cardiology 2018. Part 1 of 2: Positron emission tomography, computed tomography, and magnetic resonance.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019Review
- Prediction of the Culprit Vessel using Territorial Longitudinal Strain in Non-ST-segment Elevation Myocardial Infarction.Journal of cardiovascular echographyArticle
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn patients presenting with non-ST-elevation myocardial infarction (NSTEMI), left anterior descending (LAD) coronary artery and three-vessel disease are the most commonly encountered culprit lesions in the presence of ST depression, while one third of patients with left circumflex (LCX) artery related infarction have normal ECG. We sought to determine the predictors of presence of culprit lesion in NSTEMI patients based on ECG, echocardiographic, and clinical characteristics.
methodsPatients admitted to the coronary care unit with the diagnosis of NSTEMI between June 2012 and December 2013 were retrospectively identified. Admission ECG was interpreted by an electrophysiologist that was blinded to the result of the coronary angiogram. Patients were dichotomized into either normal or abnormal ECG group. The primary endpoint was presence of culprit lesion. Secondary endpoints included length of stay, re-hospitalization within 60 days, and in-hospital mortality.
resultsA total of 118 patients that were identified; 47 with normal and 71 with abnormal ECG. At least one culprit lesion was identified in 101 patients (86%), and significantly more among those with abnormal ECG (91.5% vs. 76.6%, P=0.041).The LAD was the most frequently detected culprit lesion in both groups. There was a higher incidence of two and three-vessel disease in the abnormal ECG group (P=0.041).On the other hand, there was a trend of higher LCX involvement (25% vs. 13.8%, P=0.18) and more normal coronary arteries in the normal ECG group (23.4% vs. 8.5%, P=0.041). On multivariate analysis, prior history of coronary artery disease (CAD) [odds ratio (OR) 6.4 (0.8-52)], male gender [OR 5.0 (1.5-17)], and abnormal admission ECG [OR 3.6 (1.12-12)], were independent predictors of a culprit lesion. There was no difference in secondary endpoints between those with normal and abnormal ECG.
conclusionsAmong patients presenting with NSTEMI, prior history of CAD, male gender and abnormal admission ECG were independent predictors of a culprit lesion. An abnormal ECG was significantly associated with two and three-vessel disease, while normal ECG was more associated with LCX involvement or normal angiogram. Admission ECG did not impact secondary outcomes.
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