title: ST segment shift in unstable angina: pathophysiology and association with coronary anatomy and hospital outcome.
abstract: The significance of ST segment shift with respect to coronary anatomy and hospital outcome was evaluated in 135 patients with unstable angina. ST shift was evident in 44% of patients on admission electrocardiogram (ECG) and in 66% on Holter monitor ECG. During hospitalization, 7% of patients had myocardial infarction, 4% died and 34% had urgent coronary revascularization. By comparing patients with and without ST shift on admission ECG, an unfavorable outcome was found in 55% versus 25% (p less than 0.005), multivessel disease in 77% versus 63% (p less than 0.05) and left main coronary artery stenosis in 22% versus 7% (p less than 0.025). When patients with and without ST shift on Holter monitor ECG were compared, an unfavorable outcome was found in 48% versus 20% (p less than 0.005), multivessel disease in 76% versus 54% (p less than 0.01) and left main coronary stenosis in 18% versus 4% (p less than 0.05). The duration of ST shift was also greater in patients with 1) unfavorable outcome (129 +/- 136 versus 52 +/- 111 min, p less than 0.01); 2) multivessel disease (98 +/- 129 versus 36 +/- 90 min, p less than 0.01); and 3) left main stenosis (150 +/- 147 versus 67 +/- 114 min, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
authors: Division of Cardiology, St. Michael's Hospital, Toronto, Ontario, Canada.
authors: A
authors: A
authors: Langer
authors: M R
authors: MR
authors: Freeman
authors: P W
authors: PW
authors: Armstrong
mesh_terms: D000787:Angina Pectoris / Q000503:physiopathology*; D000789:Angina, Unstable / Q000150:complications / Q000503:physiopathology*; D000792:Angiography; D001794:Blood Pressure; D003251:Constriction, Pathologic / Q000150:complications; D001026:Coronary Artery Bypass; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography; D004630:Emergencies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D009203:Myocardial Infarction / Q000209:etiology*; D011379:Prognosis