Prediction of significant left main coronary artery stenosis by the 12-lead electrocardiogram in patients with rest angina pectoris and the withholding of clopidogrel therapy.
We report the prospective use of an electrocardiographic sign--lead aVR ST-segment elevation greater than that seen in lead V(1)--in patients with an acute coronary syndrome as a method to prompt early angiography, to withhold clopidogrel therapy, and to perform urgent coronary bypass surgery leading to successful clinical outcomes.
D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis* / Q000209:etiology; D000077144:Clopidogrel; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis* / Q000628:therapy*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013988:Ticlopidine / Q000008:administration & dosage* / Q000031:analogs & derivatives; D028761:Withholding Treatment
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine