Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction

Previously reported electrocardiographic (ECG) criteria to distinguish left circumflex (LCCA) and right coronary artery (RCA) occlusion in patients with acute inferior ST-segment elevation myocardial infarction (STEMI) afford a modest diagnostic accuracy. We aimed to develop a new algorithm overcomi...

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Autores: Vives-Borrás, Miquel|||0000-0002-5345-4124, Maestro, Alba|||0000-0003-1785-3125, García-Hernando, Victor, Jorgensen, D., Ferrero-Gregori, Andreu|||0000-0001-6492-2416, Moustafa, Abdel Hakim|||0000-0001-6077-6888, Solé González, Eduard|||0000-0002-5727-9925, Noriega, Francisco J.|||0000-0003-3198-8552, Alvarez-Garcia, Jesus|||0000-0002-2015-6446, Cinca, Juan|||0000-0003-4819-4265
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:223331
Acceso en línea:https://ddd.uab.cat/record/223331
https://dx.doi.org/urn:doi:10.1016/j.amjcard.2018.12.026
Access Level:acceso abierto
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spelling Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial InfarctionVives-Borrás, Miquel|||0000-0002-5345-4124Maestro, Alba|||0000-0003-1785-3125García-Hernando, VictorJorgensen, D.Ferrero-Gregori, Andreu|||0000-0001-6492-2416Moustafa, Abdel Hakim|||0000-0001-6077-6888Solé González, Eduard|||0000-0002-5727-9925Noriega, Francisco J.|||0000-0003-3198-8552Alvarez-Garcia, Jesus|||0000-0002-2015-6446Cinca, Juan|||0000-0003-4819-4265Previously reported electrocardiographic (ECG) criteria to distinguish left circumflex (LCCA) and right coronary artery (RCA) occlusion in patients with acute inferior ST-segment elevation myocardial infarction (STEMI) afford a modest diagnostic accuracy. We aimed to develop a new algorithm overcoming limitations of previous studies. Clinical, ECG, and coronary angiographic data were analyzed in 230 nonselected patients with acute inferior STEMI who underwent primary percutaneous coronary intervention. A decision-tree analysis was used to develop a new ECG algorithm. The diagnostic accuracy of reported ECG criteria was reviewed. LCCA occlusion occurred in 111 cases and RCA in 119. We developed a 3-step algorithm that identified LCCA and RCA occlusion with a sensitivity of 77%, specificity of 86%, accuracy of 82%, and Youden index of 0.63. The area under the ROC curve was 0.85 and resulted 0.82 after a 10-fold cross validation. The key leads for LCCA occlusion were V3 (ST depression in V3/ST elevation in III.Universitat Autònoma de Barcelona 22019-01-0120192019-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/223331https://dx.doi.org/urn:doi:10.1016/j.amjcard.2018.12.026reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengInstituto de Salud Carlos III https://doi.org/10.13039/501100004587 RD12-0042-0002open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2233312026-06-06T12:50:31Z
dc.title.none.fl_str_mv Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
title Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
spellingShingle Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
Vives-Borrás, Miquel|||0000-0002-5345-4124
title_short Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
title_full Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
title_fullStr Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
title_full_unstemmed Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
title_sort Electrocardiographic Distinction of Left Circumflexand Right Coronary Artery Occlusion in PatientsWith Inferior Acute Myocardial Infarction
dc.creator.none.fl_str_mv Vives-Borrás, Miquel|||0000-0002-5345-4124
Maestro, Alba|||0000-0003-1785-3125
García-Hernando, Victor
Jorgensen, D.
Ferrero-Gregori, Andreu|||0000-0001-6492-2416
Moustafa, Abdel Hakim|||0000-0001-6077-6888
Solé González, Eduard|||0000-0002-5727-9925
Noriega, Francisco J.|||0000-0003-3198-8552
Alvarez-Garcia, Jesus|||0000-0002-2015-6446
Cinca, Juan|||0000-0003-4819-4265
author Vives-Borrás, Miquel|||0000-0002-5345-4124
author_facet Vives-Borrás, Miquel|||0000-0002-5345-4124
Maestro, Alba|||0000-0003-1785-3125
García-Hernando, Victor
Jorgensen, D.
Ferrero-Gregori, Andreu|||0000-0001-6492-2416
Moustafa, Abdel Hakim|||0000-0001-6077-6888
Solé González, Eduard|||0000-0002-5727-9925
Noriega, Francisco J.|||0000-0003-3198-8552
Alvarez-Garcia, Jesus|||0000-0002-2015-6446
Cinca, Juan|||0000-0003-4819-4265
author_role author
author2 Maestro, Alba|||0000-0003-1785-3125
García-Hernando, Victor
Jorgensen, D.
Ferrero-Gregori, Andreu|||0000-0001-6492-2416
Moustafa, Abdel Hakim|||0000-0001-6077-6888
Solé González, Eduard|||0000-0002-5727-9925
Noriega, Francisco J.|||0000-0003-3198-8552
Alvarez-Garcia, Jesus|||0000-0002-2015-6446
Cinca, Juan|||0000-0003-4819-4265
author2_role author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
description Previously reported electrocardiographic (ECG) criteria to distinguish left circumflex (LCCA) and right coronary artery (RCA) occlusion in patients with acute inferior ST-segment elevation myocardial infarction (STEMI) afford a modest diagnostic accuracy. We aimed to develop a new algorithm overcoming limitations of previous studies. Clinical, ECG, and coronary angiographic data were analyzed in 230 nonselected patients with acute inferior STEMI who underwent primary percutaneous coronary intervention. A decision-tree analysis was used to develop a new ECG algorithm. The diagnostic accuracy of reported ECG criteria was reviewed. LCCA occlusion occurred in 111 cases and RCA in 119. We developed a 3-step algorithm that identified LCCA and RCA occlusion with a sensitivity of 77%, specificity of 86%, accuracy of 82%, and Youden index of 0.63. The area under the ROC curve was 0.85 and resulted 0.82 after a 10-fold cross validation. The key leads for LCCA occlusion were V3 (ST depression in V3/ST elevation in III.
publishDate 2019
dc.date.none.fl_str_mv 2
2019-01-01
2019
2019-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/223331
https://dx.doi.org/urn:doi:10.1016/j.amjcard.2018.12.026
url https://ddd.uab.cat/record/223331
https://dx.doi.org/urn:doi:10.1016/j.amjcard.2018.12.026
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Instituto de Salud Carlos III https://doi.org/10.13039/501100004587 RD12-0042-0002
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by-nc-nd/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
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collection Dipòsit Digital de Documents de la UAB
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