Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment elevation.
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.
Kosuge
Masami
M
The Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.
Kimura
Kazuo
K
Ishikawa
Toshiyuki
T
Ebina
Toshiaki
T
Shimizu
Tomoaki
T
Hibi
Kiyoshi
K
Toda
Noritaka
N
Tahara
Yoshio
Y
Tsukahara
Kengo
K
Kanna
Masahiko
M
Okuda
Jyunn
J
Nozawa
Naoki
N
Ozaki
Hiroyuki
H
Yano
Hideto
H
Umemura
Satoshi
S
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
D020107:Troponin T