SynthesisAnnals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc2021
Prognostic implications of ST-segment elevation in lead aVR in patients with acute coronary syndrome: A meta-analysis.
Synthesis in Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 14 citations in OpenAlex.
- Prognostic implications of ST-segment elevation in lead aVR in patients with acute coronary syndrome: A meta-analysis.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2021Pooled it
- Prognostic Significance of aVR Lead and QTc Prolongation in Patients with Early Repolarization.Medicina (Kaunas, Lithuania) · 2025Article
- ST Elevation in aVR: An Atypical Presentation of Pulmonary Embolism.Clinical case reports · 2025Article
- Factors Associated with Mortality Risk in Patients with Cardiogenic Shock Post-ST-Elevation Myocardial Infarction: Insights from a Regional Centre in Northwest Romania.Medicina (Kaunas, Lithuania) · 2025Observational
- The Prognostic Significance of QTc Prolongation in Lead aVR in Patients with Acute Coronary Syndrome with ST Elevation or Depression.Medicina (Kaunas, Lithuania) · 2024Article
- aVR ST-segment changes and prognosis of ST-segment elevation myocardial infarction.Health science reports · 2021Article
- Article
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Authors and funding
7 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundST-segment elevation (STE) in lead aVR is a useful tool in recognizing patients with left main or left anterior descending coronary obstruction during acute coronary syndrome (ACS). The prognostic implication of STE in lead aVR on outcomes has not been established.
methodsWe performed a systematic search for clinical studies about STE in lead aVR in four databases including PubMed, EMBASE, Cochrane Library, and Web of Science. Primary outcome was in-hospital mortality. Secondary outcomes included in-hospital (re)infarction, in-hospital heart failure, and 90-day mortality.
resultsWe included 7 studies with a total of 7,700 patients. The all-cause in-hospital mortality of patients with STE in lead aVR during ACS was significantly higher than that of patients without STE (OR: 4.37, 95% CI 1.63 to 11.68, p = .003). Patients with greater STE (>0.1 mV) in lead aVR had a higher in-hospital mortality when compared to lower STE (0.05-0.1 mV) (OR: 2.00, 95% CI 1.11-3.60, p = .02), However, STE in aVR was not independently associated with in-hospital mortality in ACS patients (OR: 2.72, 95% CI 0.85-8.63, p = .09). The incidence of in-hospital myocardial (re)infarction (OR: 2.77, 95% CI 1.30-5.94, p = .009), in-hospital heart failure (OR: 2.62, 95% CI 1.06-6.50, p = .04), and 90-day mortality (OR: 10.19, 95% CI 5.27-19.71, p < .00001) was also noted to be higher in patients STE in lead aVR.
conclusionsThis contemporary meta-analysis shows STE in lead aVR is a poor prognostic marker in patients with ACS with higher in-hospital mortality, reinfarction, heart failure and 90-day mortality. Greater magnitude of STE portends worse prognosis. Further studies are needed to establish an independent predictive role of STE in aVR for these adverse outcomes.
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