title: Prehospital 12-lead ST-segment monitoring improves the early diagnosis of acute coronary syndrome.
abstract: OBJECTIVE
  We studied 620 patients who activated "911" for chest pain symptoms to determine the sensitivity and specificity of 12-lead electrocardiogram (ECG) ST-segment monitoring in the prehospital period (PH ECG) for diagnosing acute coronary syndrome (ACS) and to assess whether the addition of PH ECG signs of ischemia/injury to the initial hospital 12-lead ECG obtained in the emergency department would improve the diagnosis of ACS.
  
  
  RESULTS
  The sensitivity and specificity of the PH ECG were 65.4% and 66.4%. There was a significant increase in sensitivity (79.9%) and decrease in specificity (61.2%) when considered in conjunction with the initial hospital ECG (P < .001). Those with PH ECG ischemia/injury were more than 2.5 times likely to have an ACS diagnosis than those who had no PH ECG ischemia/injury (P < .001).
  
  
  CONCLUSIONS
  Prehospital ECG data obtained with 12-lead ST-segment monitoring provides diagnostic information about ACS above and beyond the initial hospital ECG.
authors: School of Nursing, University of California, San Francisco, CA, USA. Jessica.zegre@nursing.ucsf.edu
authors: Jessica K
authors: JK
authors: Zègre Hemsey
authors: Kathleen
authors: K
authors: Dracup
authors: Kirsten
authors: K
authors: Fleischmann
authors: Claire E
authors: CE
authors: Sommargren
authors: Barbara J
authors: BJ
authors: Drew
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology*; D000368:Aged; D002140:California / Q000453:epidemiology; D042241:Early Diagnosis; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity