Absence of ST-segment elevation in lead V1 predicts worse long-term outcomes in patients with first anterior ST-segment elevation myocardial infarction.
BACKGROUND
The prognostic value of ST-segment elevation in lead V1 (STE in V1) in anterior ST-segment elevation myocardial infarction (STEMI) has not been elucidated.


METHODS
We performed a retrospective analysis of 190 consecutive first anterior STEMI patients. STE in V1 ≥0.1mV was recorded. Major adverse cardiac events (MACE) were defined as a composite of all-cause death, recurrent myocardial infarction, or target vessel revascularization.


RESULTS
Among 190 patients, 42 patients did not have STE in V1. The patient without STE in V1 had a higher peak creatine kinase value and a higher incidence of 1-year MACE (36% vs. 13%, p<0.001), driven by a higher mortality (24% vs. 5%, p<0.001). The absence of STE in V1 was an independent predictor for 1-year MACE (odds ratio 3.16; 95% confidence interval 1.28-7.83; p=0.01).


CONCLUSIONS
The absence of STE in V1 was an independent predictor for worse long-term outcomes in patients with first anterior STEMI.
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA. Electronic address: nmisumida@chpnet.org.
Naoki
N
Misumida
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
Akihiro
A
Kobayashi
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
Shunsuke
S
Aoi
Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
John T
JT
Fox
Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
Paul
P
Schweitzer
Department of Cardiology, Mount Sinai Beth Israel, NY, USA.
Yumiko
Y
Kanei
D000368:Aged; D015984:Causality; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000401:mortality*; D003936:Diagnosis, Computer-Assisted / Q000379:methods / Q000706:statistics & numerical data; D004562:Electrocardiography / Q000379:methods / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D009518:New York / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D015996:Survival Rate
Acute coronary syndrome; Electrocardiography; Lead V1; Mortality; ST-segment elevation myocardial infarction