The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome
Badry, M., Elmaghraby, K., Helmy, H., Demitry, S. (2018). The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome. EKB Journal Management System, 3(2), 100-105. doi: 10.4103/JCMRP.JCMRP_10_18
Mohammad F. Badry; Khaled M. Elmaghraby; Hatem A. Helmy; Salwa R. Demitry. "The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome". EKB Journal Management System, 3, 2, 2018, 100-105. doi: 10.4103/JCMRP.JCMRP_10_18
Badry, M., Elmaghraby, K., Helmy, H., Demitry, S. (2018). 'The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome', EKB Journal Management System, 3(2), pp. 100-105. doi: 10.4103/JCMRP.JCMRP_10_18
Badry, M., Elmaghraby, K., Helmy, H., Demitry, S. The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome. EKB Journal Management System, 2018; 3(2): 100-105. doi: 10.4103/JCMRP.JCMRP_10_18

The added value of ST-elevation in lead aVR to clinical thrombolysis in myocardial infarction risk score in predicting the angiographic severity and extent of coronary artery disease in patients with non-ST-elevation acute coronary syndrome

Journal of Current Medical Research and Practice
Volume 3, Issue 2, May 2018, Page 100-105  XML PDF (220.84 K)
DOI: 10.4103/JCMRP.JCMRP_10_18
View on SCiNiTO View on SCiNiTO
Authors
Mohammad F. Badry; Khaled M. Elmaghrabyorcid ; Hatem A. Helmy; Salwa R. Demitry
Abstract
Introduction
The use of ST-segment elevation (STE) in lead aVR in addition to thrombolysis in myocardial infarction (TIMI) risk score may improve the early risk stratification and the management of patients at high-risk coronary artery disease, with subsequent effect on morbidity and mortality.
Patients and methods
A total of 65 patients who underwent coronary angiograms in Sohag Heart Specialized Center in the period between September 2013 and March 2014 were the participants of the study. All patients were subjected to full history taking, clinical evaluation, laboratory investigations, ECGs, TIMI scoring, and coronary angiography by femoral approach.
Results
Of the 65 patients, 59 patients were found to have significant coronary artery disease with 39 of them had STE in aVR lead, and none of the normal coronary angiography (CA) cases had STE in this lead. Of the 39 with STE-aVR, 13 patients had left main disease and 30 of them had multivessel disease. ST-aVR was elevated in 17 cases with low or intermediate risk according to TIMI score (9.1 and 55% of both groups, respectively), and was normal in three (12%) of the patients with high-risk TIMI score. Thus, STE-aVR could predict another 28.8% of high-risk cases that would not be detected by TIMI.
Conclusion
STE in lead aVR has a diagnostic and prognostic value in patients with non-STE acute coronary syndrome and may provide an additional prognostic value to the conventional cardiovascular risk factors, particularly in patients from the TIMI low-risk and intermediate-risk groups.
Keywords
Acute Coronary Syndrome; Angiography; AVR; Coronary; Infarction; non-ST-segment elevation; TIMI; eCG
Statistics
Article View: 73
PDF Download: 35