title: Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment elevation.
abstract: To identify an early, simple, noninvasive predictor of left main (LM) or 3-vessel disease (3-VD), we retrospectively studied clinical variables on admission in 310 patients with acute coronary syndromes with non-ST-segment elevation. Univariate analysis indicated that many factors were related to LM/3-VD. Multivariate analysis showed that ST-segment elevation in lead aVR of >/=0.5 mm was the strongest predictor of LM/3-VD, followed by positive troponin T (odds ratio 19.7, p <0.001, and odds ratio 3.08, p = 0.048, respectively). ST-segment elevation in lead aVR of >/=0.5 mm and positive troponin T identified LM/3-VD with sensitivities of 78% and 62%, specificities of 86% and 59%, positive predictive values of 57% and 26%, and negative predictive values of 95% and 87%, respectively (p <0.05). Our findings suggest that in patients with non-ST-segment elevation acute coronary syndromes, ST-segment elevation in lead aVR of >/=0.5 mm and positive troponin T on admission (especially the former) are useful predictors of LM/3-VD.
authors.affiliation: The Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
authors.forename: Masami
authors.initials: M
authors.lastname: Kosuge
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Ishikawa
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ebina
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Shimizu
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Hibi
authors.forename: Noritaka
authors.initials: N
authors.lastname: Toda
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Tahara
authors.forename: Kengo
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kanna
authors.forename: Jyunn
authors.initials: J
authors.lastname: Okuda
authors.forename: Naoki
authors.initials: N
authors.lastname: Nozawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ozaki
authors.forename: Hideto
authors.initials: H
authors.lastname: Yano
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000175:diagnosis / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome; D020107:Troponin T / Q000097:blood
chemical_list: D020107:Troponin T