Evaluation of electrocardiographic algorithms in the assessment of the infarct-related artery in acute myocardial infarction.
OBJECTIVE
In acute myocardial infarction, it is of great value to identify the infarct-related artery and the site of occlusion in a coronary artery (proximal versus distal). This study assessed the diagnostic value of two previously published electrocardiographic algorithms to identify the infarct-related artery and the site of occlusion in anterior and inferior acute myocardial infarction.


RESULTS
We studied retrospectively a group of 88 patients with a first myocardial infarction. We determined the infarct-related artery using the electrocardiographic algorithms on the electrocardiogram at the time of admission and compared these results with the angiographically determined infarct-related artery. The best electrocardiographic algorithm could determine the infarct-related artery in an inferior myocardial infarction as the left circumflex coronary artery and as the proximal and distal right coronary artery with a sensitivity of 63%, 67% and 80%, respectively, and a specificity of 100%, 82% and 69%, respectively. One algorithm was unable to diagnose a left circumflex coronary artery occlusion. In an anterior myocardial infarction the best electrocardiographic algorithm could determine the infarct-related artery as the proximal and distal left anterior descending coronary artery with a sensitivity of 85% and 80%, respectively, and with a specificity of 77% and 82%, respectively.


CONCLUSIONS
In acute myocardial infarction the use of electrocardiographic algorithms is helpful to predict the site of occlusion and can play a crucial role in the care of patients.
Witters
Peter Gerard Julia
PG
Catholic University of Leuven, Leuven, Belgium. Peter.Witters@student.kuleuven.be
Cools
Frank Johan
FJ
D000368:Aged; D000465:Algorithms; D017023:Coronary Angiography / Q000379:methods; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D003331:Coronary Vessels / Q000473:pathology; D003936:Diagnosis, Computer-Assisted / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity