ArticleInternational journal of cardiology. Heart & vasculature2021
Accuracy of OMI ECG findings versus STEMI criteria for diagnosis of acute coronary occlusion myocardial infarction.
Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05705102 (Time for a DIagnostic Paradigm Shift From ST-elevation/Non-ST-elevation to OCClUsion/Non-occLusion Myocardial infarcTion?), which is not on this map. Cited by 62 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Time for a DIagnostic Paradigm Shift From ST-elevation/Non-ST-elevation to OCClUsion/Non-occLusion Myocardial infarcTion?
Who cites it
62 citing papers in PubMed, 1 synthesis or guideline pooled it.
- National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand: Australian Clinical Guideline for Diagnosing and Managing Acute Coronary Syndromes 2025.The Medical journal of Australia · 2026Guideline
- Improved Detection of Acute Coronary Occlusion Myocardial Infarction by an Artificial Intelligence Electrocardiogram Model in Swedish Emergency Departments.Journal of the American College of Emergency Physicians open · 2026Article
- A Wearable Infrared Sensor for Detecting Non-ST Segment Elevation Acute Coronary Syndromes.Life (Basel, Switzerland) · 2026Article
- Novel machine learning fusion architectures integrating electrocardiogram representations: applications to acute coronary event detection.European heart journal. Digital health · 2026Article
- Acute Coronary Syndrome Risk Prediction Using Portable Cable-Free ECG Device Combined With Clinical Risk Assessment.JACC. Advances · 2026Article
- The impact of emergency quality improvement program on the prognosis of patients with acute ST-segment elevation myocardial infarction in Taiwan.Scientific reports · 2026Article
- Acute Coronary Occlusion in NSTEMI Patients: Prevalence, Clinical Characteristics and the Potential Role of Artificial Intelligence.Medicina (Kaunas, Lithuania) · 2026Article
- The Prognostic-Diagnostic paradox of lead aVR: From 'STEMI-Equivalent' to 'High-Risk NOMI' in the era of precision cardiology.International journal of cardiology. Heart & vasculature · 2026Review
- Prioritizing Electrocardiogram Interpretation for Emergency Medicine Residency Training: A Modified Delphi Study.AEM education and training · 2026Article
- AI-Enhanced Electrocardiogram for Detection of Occlusive Myocardial Infarction in High-Risk Non-ST-Segment Elevation Acute Coronary Syndrome.JACC. Advances · 2026Article
- Detecting Occlusion Myocardial Infarction with an AI-Powered ECG Model: A Retrospective Cohort Study.Journal of personalized medicine · 2026Article
- Review
- An artificial intelligence model for electrocardiogram detection of occlusion myocardial infarction: a retrospective study to reduce false-positive cath lab activations.European heart journal. Digital health · 2026Article
- Diagnostic challenges in acute coronary syndrome: reconciling the STEMI-NSTEMI and OMI-NOMI paradigms.BMC cardiovascular disorders · 2026Article
- Predicting Occlusion Myocardial Infarctions in the Emergency Department Using Artificial Intelligence.Journal of the American College of Emergency Physicians open · 2026Article
- AI-Enabled regional tele-ECG cloud platform and improving access to cardiovascular diagnosis: real-world evidence from southern China.Frontiers in cardiovascular medicine · 2026Article
- Angiographic prevalence of occlusion myocardial infarction and the limited value of serial troponin in patients with non-ST-segment elevation acute coronary syndrome.Frontiers in cardiovascular medicine · 2026Article
- Comparison of regional wall motion abnormalities in patients with occlusion myocardial infarction with and without ST-elevation myocardial infarction (STEMI).Clinical and experimental emergency medicine · 2025Article
- ECG-SMART-NET: A Deep Learning Architecture for Precise ECG Diagnosis of Occlusion Myocardial Infarction.IEEE transactions on bio-medical engineering · 2025Article
- Systematic Review of Artificial Intelligence and Electrocardiography for Cardiovascular Disease Diagnosis.Bioengineering (Basel, Switzerland) · 2025Review
2 more citing papers are in PubMed but not listed here.
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn the STEMI paradigm of Acute Myocardial Infarction (AMI), many NSTEMI patients have unrecognized acute coronary occlusion MI (OMI), may not receive emergent reperfusion, and have higher mortality than NSTEMI patients without occlusion. We have proposed a new OMI vs. Non-Occlusion MI (NOMI) paradigm shift. We sought to compare the diagnostic accuracy of OMI ECG findings vs. formal STEMI criteria for the diagnosis of OMI. We hypothesized that blinded interpretation for predefined OMI ECG findings would be more accurate than STEMI criteria for the diagnosis of OMI.
methodsWe performed a retrospective case-control study of patients with suspected acute coronary syndrome. The primary definition of OMI was either 1) acute TIMI 0-2 flow culprit or 2) TIMI 3 flow culprit with peak troponin T
results808 patients were included, of whom 49% had AMI (33% OMI; 16% NOMI). Sensitivity, specificity, and accuracy of STEMI criteria vs Interpreter 1 using OMI ECG findings among 808 patients were 41% vs 86%, 94% vs 91%, and 77% vs 89%, and for Interpreter 2 among 250 patients were 36% vs 80%, 91% vs 92%, and 76% vs 89%. STEMI(-) OMI patients had similar infarct size and mortality as STEMI(+) OMI patients, but greater delays to angiography.
conclusionsBlinded interpretation using predefined OMI ECG findings was superior to STEMI criteria for the ECG diagnosis of Occlusion MI. These data support further investigation into the OMI vs. NOMI paradigm and suggest that STEMI(-) OMI patients could be identified rapidly and noninvasively for emergent reperfusion using more accurate ECG interpretation.
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