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2019, Number 4

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Rev Cubana Cardiol Cir Cardiovasc 2019; 25 (4)

Severe coronary artery disease and ST segment shift in lead aVR in non ST segment elevation acute Coronary Syndrome

García HRA, Rivero SL, Hernández NM, Aldama PLI, Aroche AR, Martínez MJO

Language: Spanish
References: 23
Page:
PDF size: 829.86 Kb.


ABSTRACT

Introduction: ST-segment shift in lead aVR is associated with increased coronary aterosclerosis. However, there is insufficient data about it relationship with coronary complexity.
Objetive: To determinate the contribution of ST segment shif in lead aVR in diagnosis of complex coronary heart disease comfirm after by angiography.
Method: Analytic, cross sectional study in patients with non ST segment elevation acute coronary syndrome hospitalized in Coronary Care Unit at Hospital Hermanos Ameijeiras and Hospital Enrique Cabrera from may 2011 to may 2017.
Results: Male patients (52,9 %) with a mean age 66,0 ± 8,0 and more than two comorbidities (92,2 %) were predominant. Left main disease (99,3 %) and multivessels disease (43 %) with stenosis ≥ 70 % (94,4 %) were more frequent in ST segment shitf lead aVR> 1 mm. Also in this group B2 and C lesion type were predominant (73,2 and 87,5 %). A sensibility of 84,5 % and specificity of 69,8 % was obtained for the diagnosis of complex coronary heart disease with an area under the curve of 0,893 (IC 95 %= 0,879-0,907; p=0,00). The positive predictive value was 81,6 % and the negative predictive value was 74,3 %.
Conclusion: ST segment shift in lead aVR ≥ 1,0 mm was an important predictor of complex coronary heart disease in non ST segment elevation acute coronary syndrome.


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