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Article: Clinical implications of precordial ST-segment elevation in acute inferoposterior myocardial infarction caused by proximal right coronary artery occlusion

TitleClinical implications of precordial ST-segment elevation in acute inferoposterior myocardial infarction caused by proximal right coronary artery occlusion
Authors
KeywordsAged
Coronary Stenosis/*complications/physiopathology
*Electrocardiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction/etiology/*physiopathology
Prognosis
Retrospective Studies
Severity of Illness Index
Stroke Volume/physiology
Ventricular Function, Left/physiology
Issue Date2007
Citation
Clin Cardiol, 2007, v. 30 n. 7, p. 331-335 How to Cite?
AbstractBACKGROUND: The clinical significance of inferior wall acute myocardial infarction (MI) with combined ST-segment elevation in both anterior and inferior leads, compared with inferior leads alone, is unknown. HYPOTHESIS: Despite having more leads with precordial ST-segment elevation, these patients may have a better outcome due to less posterior involvement, which tends to drag down the precordial ST-segment. METHODS: A total of 158 postinferior MI patients with documented proximal right coronary artery occlusion were retrospectively studied. They were divided into three subgroups according to the magnitude of concurrent ST-segment deviation in lead V2: Group A (n = 19) had ST-segment elevation >/= 2.0 mm; Group B (n = 74) had ST-segment lay between + 2.0 mm and - 2.0 mm; and Group C (n = 65) had ST-segment depression >/= 2.0 mm. The clinical and electrocardiographic characteristics were then compared among these threes subgroups. RESULTS: The baseline demography, prevalence of risk factors, and treatment received were of no difference among the subgroups. However, Group A patients had significantly lower peak creatinine phosphokinase level and more preserved left ventricular function than Group B and C. Moreover, they had lower total sum of inferior ST-segment magnitude, less ST-segment depression in V4-6, and more ST-segment elevation in V(4R) than Group C. Group C patients had highest in-hospital and one-year mortality although it did not reach statistical significance. CONCLUSIONS: Precordial ST-segment elevation in inferior wall acute MI was associated with smaller infarct size and better left ventricular function, probably secondary to occlusion of a less dominant RCA, which did not result in a significant posterior infarction.
Persistent Identifierhttp://hdl.handle.net/10722/207697
ISSN
2015 Impact Factor: 2.431
2015 SCImago Journal Rankings: 1.309

 

DC FieldValueLanguage
dc.contributor.authorJim, MHen_US
dc.contributor.authorChan, OOAen_US
dc.contributor.authorWong, CPen_US
dc.contributor.authorYiu, KHen_US
dc.contributor.authorMiu, Ren_US
dc.contributor.authorLee, WLSen_US
dc.contributor.authorLau, CPen_US
dc.date.accessioned2015-01-19T04:20:34Z-
dc.date.available2015-01-19T04:20:34Z-
dc.date.issued2007en_US
dc.identifier.citationClin Cardiol, 2007, v. 30 n. 7, p. 331-335en_US
dc.identifier.issn0160-9289en_US
dc.identifier.urihttp://hdl.handle.net/10722/207697-
dc.description.abstractBACKGROUND: The clinical significance of inferior wall acute myocardial infarction (MI) with combined ST-segment elevation in both anterior and inferior leads, compared with inferior leads alone, is unknown. HYPOTHESIS: Despite having more leads with precordial ST-segment elevation, these patients may have a better outcome due to less posterior involvement, which tends to drag down the precordial ST-segment. METHODS: A total of 158 postinferior MI patients with documented proximal right coronary artery occlusion were retrospectively studied. They were divided into three subgroups according to the magnitude of concurrent ST-segment deviation in lead V2: Group A (n = 19) had ST-segment elevation >/= 2.0 mm; Group B (n = 74) had ST-segment lay between + 2.0 mm and - 2.0 mm; and Group C (n = 65) had ST-segment depression >/= 2.0 mm. The clinical and electrocardiographic characteristics were then compared among these threes subgroups. RESULTS: The baseline demography, prevalence of risk factors, and treatment received were of no difference among the subgroups. However, Group A patients had significantly lower peak creatinine phosphokinase level and more preserved left ventricular function than Group B and C. Moreover, they had lower total sum of inferior ST-segment magnitude, less ST-segment depression in V4-6, and more ST-segment elevation in V(4R) than Group C. Group C patients had highest in-hospital and one-year mortality although it did not reach statistical significance. CONCLUSIONS: Precordial ST-segment elevation in inferior wall acute MI was associated with smaller infarct size and better left ventricular function, probably secondary to occlusion of a less dominant RCA, which did not result in a significant posterior infarction.en_US
dc.languageengen_US
dc.relation.ispartofClin Cardiolen_US
dc.subjectAgeden_US
dc.subjectCoronary Stenosis/*complications/physiopathologyen_US
dc.subject*Electrocardiographyen_US
dc.subjectFemaleen_US
dc.subjectFollow-Up Studiesen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectMyocardial Infarction/etiology/*physiopathologyen_US
dc.subjectPrognosisen_US
dc.subjectRetrospective Studiesen_US
dc.subjectSeverity of Illness Indexen_US
dc.subjectStroke Volume/physiologyen_US
dc.subjectVentricular Function, Left/physiologyen_US
dc.titleClinical implications of precordial ST-segment elevation in acute inferoposterior myocardial infarction caused by proximal right coronary artery occlusionen_US
dc.typeArticleen_US
dc.identifier.emailYiu, KH: khkyiu@hku.hken_US
dc.identifier.authorityYiu, KH=rp01490en_US
dc.identifier.doi10.1002/clc.20096en_US
dc.identifier.volume30en_US
dc.identifier.issue7en_US
dc.identifier.spage331en_US
dc.identifier.epage335en_US

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