2.50
Hdl Handle:
http://hdl.handle.net/10755/156952
Category:
Abstract
Type:
Presentation
Title:
Dangerous ST Depression Associated with Left Main
Author(s):
Barbara, Victoria A.; Selvester, Ronald; Zhou, Sophia
Author Details:
Victoria A. Barbara, Alabama, USA, email: vbarbara@memorialcare.org; Ronald Selvester; Sophia Zhou
Abstract:
POSTER PURPOSE: Acute cardiac global ischemia is associated with high-grade occlusion of the left main coronary artery or occlusions in multiple coronary arteries, and it is defined as non-ST elevation myocardial infarct (NSTEMI). The purpose of our study was to investigate the electrocardiographic (ECG) pattern and diagnostic ECG criteria for acute cardiac global ischemia from a large population with acute coronary syndrome (ACS). BACKGROUND/SIGNIFICANCE:STEMI and NSTEMI are regarded as dangerous conditions with poor prognosis and similar mortality. However, NSTEMI patients undergo less and later reperfusion therapy than do STEMI patients. Researchers have recently found that massive ST-segment depression in defused leads is often associated with acute high-grade occlusion in the left main coronary artery or equivalent multivessel occlusion. ACS patients with evidence of acute cardiac global ischemia require immediate reperfusion therapy. METHOD: We collected 12-lead ECG records from patients with suspected ACS presenting to the emergency department at Long Beach Memorial Medical Center. Excluding individuals with known ECG confounders, the test set (N=778) included 29 patients with angiographically confirmed occlusion of the left main coronary artery or high-grade occlusion in 3 main coronary arteries, individuals without acute MI (n = 571) or with acute MI but catheterization findings of a single culprit artery (n = 178). ECGs from age-, sex-, and ACS-matched patients without a discharge diagnosis of acute MI were collected as a control group (N = 1107). The ECG criteria applied included ST-segment depression >100 ¦V in more than 6 leads and ST-segment elevation greater than 70 ¦V in lead aVR. RESULTS: On the basis of the ECG criteria applied, we obtained a sensitivity of 62% (95% confidence interval (CI), 44%û77%) and a specificity of 100% (95% CI, 99%û100%) for the detection of acute cardiac global ischemia. The positive predictive value and negative predictive values in this test set were 90% (95% CI, 70%û97%) and 99% (95% CI, 97%û99%), respectively. CONCLUSIONS: Acute cardiac global ischemia is a relatively new finding and poses a high risk in ACS patients. Early recognition of this clinical condition in emergency departments and cardiac care units can shorten the time to reperfusion and improve the clinical outcome. A diagnostic 12-lead ECG can be very useful to recognize acute cardiac global ischemia so those patients can receive more aggressive perfusion therapy.
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleDangerous ST Depression Associated with Left Mainen_GB
dc.contributor.authorBarbara, Victoria A.en_GB
dc.contributor.authorSelvester, Ronalden_GB
dc.contributor.authorZhou, Sophiaen_GB
dc.author.detailsVictoria A. Barbara, Alabama, USA, email: vbarbara@memorialcare.org; Ronald Selvester; Sophia Zhouen_GB
dc.identifier.urihttp://hdl.handle.net/10755/156952-
dc.description.abstractPOSTER PURPOSE: Acute cardiac global ischemia is associated with high-grade occlusion of the left main coronary artery or occlusions in multiple coronary arteries, and it is defined as non-ST elevation myocardial infarct (NSTEMI). The purpose of our study was to investigate the electrocardiographic (ECG) pattern and diagnostic ECG criteria for acute cardiac global ischemia from a large population with acute coronary syndrome (ACS). BACKGROUND/SIGNIFICANCE:STEMI and NSTEMI are regarded as dangerous conditions with poor prognosis and similar mortality. However, NSTEMI patients undergo less and later reperfusion therapy than do STEMI patients. Researchers have recently found that massive ST-segment depression in defused leads is often associated with acute high-grade occlusion in the left main coronary artery or equivalent multivessel occlusion. ACS patients with evidence of acute cardiac global ischemia require immediate reperfusion therapy. METHOD: We collected 12-lead ECG records from patients with suspected ACS presenting to the emergency department at Long Beach Memorial Medical Center. Excluding individuals with known ECG confounders, the test set (N=778) included 29 patients with angiographically confirmed occlusion of the left main coronary artery or high-grade occlusion in 3 main coronary arteries, individuals without acute MI (n = 571) or with acute MI but catheterization findings of a single culprit artery (n = 178). ECGs from age-, sex-, and ACS-matched patients without a discharge diagnosis of acute MI were collected as a control group (N = 1107). The ECG criteria applied included ST-segment depression >100 ¦V in more than 6 leads and ST-segment elevation greater than 70 ¦V in lead aVR. RESULTS: On the basis of the ECG criteria applied, we obtained a sensitivity of 62% (95% confidence interval (CI), 44%û77%) and a specificity of 100% (95% CI, 99%û100%) for the detection of acute cardiac global ischemia. The positive predictive value and negative predictive values in this test set were 90% (95% CI, 70%û97%) and 99% (95% CI, 97%û99%), respectively. CONCLUSIONS: Acute cardiac global ischemia is a relatively new finding and poses a high risk in ACS patients. Early recognition of this clinical condition in emergency departments and cardiac care units can shorten the time to reperfusion and improve the clinical outcome. A diagnostic 12-lead ECG can be very useful to recognize acute cardiac global ischemia so those patients can receive more aggressive perfusion therapy.en_GB
dc.date.available2011-10-26T19:17:22Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:17:22Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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