Jeopardised Inferior Myocardium (JIM) score: an arithmetic electrocardiographic score to predict the infarct-related artery in inferior myocardial infarction.
BACKGROUND
A few electrocardiographic criteria have been described to identify the infarct-related artery in inferior myocardial infarction. The aim of this study was to devise an arithmetic score to further improve the diagnostic accuracy.


METHODS
From 2004 to 2006, 78 patients who underwent primary angioplasty for inferior myocardial infarction within 6 hours from symptom onset were recruited for electrocardiographic and angiographic analysis.


RESULTS
The mean age of patients was 65 ± 12 years with male predominance (74%). Less ST depression in lead I and aVL, and more prominent ST depression in lead V1-3 were observed in left circumflex artery (LCX) than right coronary artery (RCA) occlusions. In addition, more prominent ST depression in lead I and ST elevation in V1 were found in proximal RCA than distal RCA occlusions. Based on the findings, the Jeopardised Inferior Myocardium (JIM) score was constructed and defi ned as [II-V3/III+V1- I]. The sensitivity and specificity of JIM score ≤0.5 to predict proximal RCA occlusions; 0.5 <JIM score ≤1.5 to predict distal RCA occlusions; and JIM score >1.5 to predict LCX occlusions were 58% and 85%, 69% and 68%, and 79% and 94%, respectively. The accuracy of prediction is slightly better than the 2 previously reported criteria.


CONCLUSIONS
By taking into account more leads, the JIM score is capable of identifying the infarct-related artery with an improved diagnostic accuracy.
Cardiac Medical Unit, Grantham Hospital, Hong Kong, ROC. jimmanh2002@yahoo.com
Man Hong
MH
Jim
Kin Lam
KL
Tsui
Kai Hang
KH
Yiu
Gary S H
GS
Cheung
Chung Wah
CW
Siu
Hee Hwa
HH
Ho
Wing Hing
WH
Chow
Shu Kin
SK
Li
D000368:Aged; D000465:Algorithms; D017023:Coronary Angiography; D054059:Coronary Occlusion / Q000175:diagnosis*; D003331:Coronary Vessels / Q000473:pathology*; D004562:Electrocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity