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Usefulness of ST depression with T-wave inversion in leads V(4) to V(6) for predicting one-year mortality in non-ST-elevation acute coronary syndrome (from the Electrocardiographic Analysis of the Global Use of Strategies to Open Occluded Coronary Arteries IIB Trial).

Publication ,  Journal Article
Atar, S; Fu, Y; Wagner, GS; Rosanio, S; Barbagelata, A; Birnbaum, Y
Published in: Am J Cardiol
April 1, 2007

ST-segment depression (ST-D) on the admission electrocardiogram of patients with non-ST-elevation acute coronary syndromes (NSTEACSs) is associated with higher mortality. However, few studies have evaluated the effect of location of ST-D and T-wave polarity on long-term prognosis of patients with NSTEACS. Electrocardiographic (ECG) and clinical data from 6,770 patients with NSTEACS randomly assigned in the Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIB trial were analyzed retrospectively. One-year mortality was correlated with location of ST-D (leads I and aVL; II, III, and aVF; V1 to V3; or V4 to V6) and T-wave polarity. ST-D in any of the ECG locations was associated with higher mortality compared with patients without ST-D. Patients with ST-D and T-wave inversion in leads V4 to V6 had the highest 1-year mortality rate of all groups (16.2%), significantly higher compared with patients with ST-D without T-wave inversion in those leads (9.0%, p=0.001). Logistic regression analysis showed that age, hyperlipidemia, Killip class>I, history of myocardial infarction, history of heart failure, history of angina pectoris, systolic blood pressure, heart rate, sum of ST-D (odds ratio 1.061, 95% confidence interval 1.035 to 1.087, p<0.001), and ST-D with T-wave inversion in leads V4 to V6 (odds ratio 1.374, 95% CI 1.023 to 1.844, p=0.035) were independent predictors of 1-year mortality. Conversely, ST-D without T-wave inversion in leads V4 to V6 or other ECG presentations were not independent predictors of high 1-year mortality. In conclusion, ST-D with T-wave inversion in leads V4 to V6 on the admission electrocardiogram in patients with NSTEACS identifies those with higher 1-year mortality than for patients with any other ECG presentation.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

April 1, 2007

Volume

99

Issue

7

Start / End Page

934 / 938

Location

United States

Related Subject Headings

  • Time Factors
  • Syndrome
  • Survival Analysis
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Male
  • Logistic Models
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Atar, Shaul, Yuling Fu, Galen S. Wagner, Salvatore Rosanio, Alejandro Barbagelata, and Yochai Birnbaum. “Usefulness of ST depression with T-wave inversion in leads V(4) to V(6) for predicting one-year mortality in non-ST-elevation acute coronary syndrome (from the Electrocardiographic Analysis of the Global Use of Strategies to Open Occluded Coronary Arteries IIB Trial).Am J Cardiol 99, no. 7 (April 1, 2007): 934–38. https://doi.org/10.1016/j.amjcard.2006.11.039.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

April 1, 2007

Volume

99

Issue

7

Start / End Page

934 / 938

Location

United States

Related Subject Headings

  • Time Factors
  • Syndrome
  • Survival Analysis
  • Retrospective Studies
  • Randomized Controlled Trials as Topic
  • Predictive Value of Tests
  • Multicenter Studies as Topic
  • Middle Aged
  • Male
  • Logistic Models