The correlation between presenting ST-segment depression and the final size of acute myocardial infarcts in patients with acute coronary syndromes

• Published in: Journal of electrocardiology Vol. 33; pp. 61 - 63
• Main Authors: Asfour, Wail, Bell, Samuel, Amkieh, Ali M., Sgarbossa, Elena B., Azzam, Ruba K., Clemmensen, Peter, Cohen, Mauricio, Eisenstein, Eric, Goodman, Shaun, Grinfeld, Liliana, Holmvang, Lene, Maynard, Charles, Pahlm, Olle, Selvester, Ronald H., Heden, Bo, Shah, Akbar, Vaught, Creighton, Warner, Robert A., Glancy, David L., Wagner, Galen S., Barbagelata, Alejandro
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2000; Elsevier Science Ltd
• Subjects: Case-Control Studies; Electrocardiography; Humans; Myocardial Infarction - physiopathology; Non Q wave MI; Q wave MI; Selvester score; ST segment depression; Syndrome; Ventricular Dysfunction - physiopathology; Q wave MI; Selvester score; Non Q wave MI; ST segment depression
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1054/jelc.2000.20338

The use of reperfusion therapy in patients with ST elevation acute coronary syndromes had been established. However, reperfusion therapy is usually considered contra-indicated in those with ST depression, despite the knowledge that regional posterior infarction is typically indicated by ST depression maximal in leads V
1 to V
3 and nonregional subendocardial infarction is typically indicated by marked ST depression maximal in other leads. This study of patients with non-ST-elevation acute coronary syndromes investigates the quantitative relationship between presenting ST depression and final QRS changes in both of these subgroups. The final QRS score was significantly higher (2.44 points) than that of a control group with not ST depression, (1.55 points) in the group with maximal ST depression in V
1 to V
3 (
P=0.04). However, in the entire population, there was a highly significant correlation (
P=.003) between the sum of the presenting ST depression and the final QRS score. Trials of reperfusion therapy will be required to determine if such evolution to electrocardiogram documented acute myocardial infarction can be prevented in patient with marked ST depression acute coronary syndromes.