Predicting the culprit artery in acute ST-elevation myocardial infarction and introducing a new algorithm to predict infarct-related artery in inferior ST-elevation myocardial infarction: correlation with coronary anatomy in the HAAMU Trial.
OBJECTIVE
The objective of this study is to predict the culprit artery from the electrocardiogram (ECG) by predefined criteria and to compare a new algorithm with a previous one for predicting the culprit artery in inferior ST-elevation myocardial infarction (STEMI).


RESULTS
In "all-comers" (n = 187) with acute STEMI, with ECG and angiography from the acute phase, the positive and negative predictive values for the prediction of the left anterior descending coronary artery, left circumflex coronary artery, or right coronary artery as the infarct-related artery were 96% and 96%, 65% and 95%, 92% and 97%, respectively. In inferior STEMI (n = 98), positive and negative predictive values to predict the right coronary artery or the left circumflex coronary artery as the culprit artery were 92% and 75% and 75% and 94%, respectively.


CONCLUSIONS
In "all-comers" with STEMI, the culprit artery could be predicted by ECG criteria with high predictive values. In inferior STEMI, a new algorithm for culprit artery prediction was successfully tested.
Tierala
Ilkka
I
Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland. shumpei_8@hotmail.com
Nikus
Kjell C
KC
Sclarovsky
Samuel
S
Syvänne
Mikko
M
Eskola
Markku
M
D000465:Algorithms; D002986:Clinical Trials as Topic; D023921:Coronary Stenosis / Q000150:complications* / Q000175:diagnosis*; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D004562:Electrocardiography / Q000379:methods*; D006801:Humans; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000209:etiology*; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic