Occurrence of anterior st depression in inferior myocardial infarction and relation to clinical outcome

Herlitz, Johan; Hjalmarson, Åke

doi:10.1002/clc.4960100914

Cited by 10 publications

(6 citation statements)

References 17 publications

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“…2 In a study by Herlitz and colleague 64% of participants had anterior ST depression. 9 Our finding of positive correlation of ST depression in anterior leads with sum of ST elevation in inferior leads was similar to that of Herlitz and colleagues who reported those with anterior ST depression had greater mean ST elevation in inferior leads (II, III, aVF). 9 Khalil and colleagues also found mean ST segment elevation significantly higher in those with precordial ST depression.…”

Section: Discussionsupporting

confidence: 91%

“…9 Our finding of positive correlation of ST depression in anterior leads with sum of ST elevation in inferior leads was similar to that of Herlitz and colleagues who reported those with anterior ST depression had greater mean ST elevation in inferior leads (II, III, aVF). 9 Khalil and colleagues also found mean ST segment elevation significantly higher in those with precordial ST depression. 10 Similar to our findings, EL Atroush and colleagues reported significantly more frequent LAD lesion in those with reciprocal ST depression.…”

Section: Discussionsupporting

confidence: 91%

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Angiographic Significance of ST Depression in Anterior Leads in Acute Inferior ST Elevation Myocardial Infarction.

Simkhada

Khan

et al. 2021

Nepalese Heart J.

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Background and aims: Electrocardiogram of acute ST elevation inferior myocardial infarction can show concomitant ST depression in anterior leads. We aimed to see its significance on coronary angiogram. Methods: Cross sectional study conducted in Department of Cardiology of Shahid Gangalal National Heart Centre from March 2021 to June 2021. Total of 64 patients of acute inferior myocardial infarction were included consecutively. Electrocardiogram were analyzed for the presence of ST depression in anterior leads (V1-V6). Coronary angiogram were obtained. Linear regression analysis was applied to see correlations. Results: Thirty-four (53.12%) participants had significant ST depression in anterior leads. Their mean age was 64.53±11.67 years. Twenty-two (64.70%) were male. Out of them, 13 (38.23%) were hypertensive, 9 (26.47%) were smoker and 7 (20.58%) were diabetic. Among 30 (46.88%) participants without ST depression, mean age was 56.73±13.31 years and 21 (70%) were male. Out of them, 11 (36.66%) were hypertensive, 12 (40%) were smoker and 11 (33.66%) were diabetic. Culprit vessel was right coronary artery in 22 (64.70%) of those with ST depression and 22 (73.33%) of those without ST depression. Significant left anterior descending artery lesion was seen in 19 (55.88%) of those with ST depression and 3 (10%) of those without depression. Anterior ST depression showed positive correlation with left anterior descending artery lesion. Conclusion: ST depression in anterior leads in acute inferior myocardial infarction can be due to presence of concomitant left anterior descending coronary artery disease.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Angiographic Significance of ST Depression in Anterior Leads in Acute Inferior ST Elevation Myocardial Infarction.

Simkhada

Khan

et al. 2021

Nepalese Heart J.

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“…As a result, patients with PSTD are proned to short term and long term complications compare to patients without PSTD. Thus, the presence of PSTD defines a high risk subset of patients with inferior MI due to a higher incidence of major adverse cardiovascular events (MACE) 3,[5][6][7] .…”

Section: Introductionmentioning

confidence: 99%

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction

Suganti

Lubis

Siregar

et al. 2019

IJC

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Background: Whether a precordial ST segment depression (PSTD) is merely a benign electrical phenomena or a sign of multivessel coronary artery disease (MVCAD) in inferior myocardial infarction (MI) remains unclear. The objective of this study is to analyze the complexity of coronary artery disease (CAD) in inferior MI patients with PSTD and to investigate whether PSTD can be used as a predictor of MVCAD in inferior MI. Methods: Patients with inferior MI were divided into two groups based on the presence of PSTD on admission ECG and were compared based on the patient's coronary artery complexities. Results: A total of 215 patients with inferior MI were found in this study period, with 102 patients meet the inclusion and exclusion criteria. Patients with PSTD had a higher incidence of MVCAD and SYNTAX score. Further analyzes showed PSTD on admission ECG was an independent predictor of MVCAD in inferior MI [45 (66%) vs 23 (34%); OR 4.097; 95% CI 1.638-10.247; p=0.003). Conclusion: In daily clinical practice, PSTD on admission ECG may serve as a simple noninvasive tool for predicting MVCAD or a more complex CAD in inferior MI. (Indonesian J Cardiol. 2019;40:312-318)

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“…STEMI with reciprocal STSD are associated with poorer in hospital and long term prognosis, and even higher mortality compared to those without reciprocal STSD. 13,14,15,16,17 Stevenson et al, tried to prove that reciprocal STSD in STEMI patients receiving fibrinolytic are associated with poorer prognosis. Buller et al, stated that resolution in reciprocal STSD soon after primary PCI turned out to be a simple prognostic parameter.…”

Section: Introductionmentioning

confidence: 99%

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

Adhitya¹,

Hasan²,

Sitepu³

et al. 2018

IJPTR

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Background: ST Elevation Myocardial Infarction (STEMI) may cause Major Cardiovascular Events (MACEs). Revascularization needs to be done in all STEMI patients to restore coronary blood flow, hence saving myocardial perfusion. Reciprocal ST Segment Depression (STSD) is associated with poor prognosis in STEMI patients receiving fibrinolytic therapy. The main purpose of this study is to evaluate MACE in STEMI patients receiving alteplase as fibrinolytic therapy using resolution in STSD. Methods: This cohort prospective study with 60 subjects of STEMI patients which are evaluated for MACEs (death, heart failure, and rehospitalization) within 30 days after myocardial infarction. Resolution in reciprocal STSD is defined as resolution ≥ 50% STSD in reciprocal leads within 90 minutes after fibrinolytic therapy. Results: Bivariate analysis showed that Ejection fraction (EF) <40% with OR 8,32 (2,11-32,74), p=0,001; smoking with OR 4,17 (1,05-16,57), p=0,034; Anterior STEMI with OR 3,94 (1,(11)(12)(13)90), p= 0,027; Creatinine > 1,97 mg/dl with OR 3,69 (1,18-11,55), p= 0,022; complete outpatient medication with OR 5,23 (1,61-17,01), p= 0,004; fragmented QRS with OR 5,23 (1,61-17,01), p= 0,001; resolution in STSD with OR 26,35 (5, 40), p=<0,001; resolution in ST Segment Elevation with OR 10,5 (2,24), p=<0,001; are proven to be determining factor for MACE within 30 days. Multivariate analysis showed that among those determining factors for MACEs, resolution in STSD in reciprocal leads is evidently the most dominant factor for predicting MACEs within 30 days in STEMI patients receiving fibrinolytic therapy .10), p=0.038]. Conclusion: There is significant difference in MACEs within 30 days after myocardial infarction (MI) between patients with and without resolution in STSD. The subjects without resolution in STSD showed higher MACEs incidence. Resolution in STSD is evidently an independent predictor for MACEs within 30 days after myocardial infarction in STEMI patients.

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Occurrence of anterior st depression in inferior myocardial infarction and relation to clinical outcome

Cited by 10 publications

References 17 publications

Angiographic Significance of ST Depression in Anterior Leads in Acute Inferior ST Elevation Myocardial Infarction.

Angiographic Significance of ST Depression in Anterior Leads in Acute Inferior ST Elevation Myocardial Infarction.

Precordial ST Segment Depression on Admission Electrocardiogram as a Simple Noninvasive Tool for Predicting Coronary Artery Disease Complexity in Patients with Inferior Myocardial Infarction

Resolution of Reciprocal ST Segment Depression as Predictor for Major Cardiovascular Events in Stemi Patients Treated with Alteplase

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