Positive T wave in lead aVR as an independent predictor for 1‐year major adverse cardiac events in patients with first anterior wall ST‐segment elevation myocardial infarction. Issue 6 (16th February 2017)

• Record Type: Journal Article
• Authors: Kobayashi, Akihiro; Misumida, Naoki; Aoi, Shunsuke; Kanei, Yumiko
• Is Part Of: Annals of noninvasive electrocardiology. Volume 22:Issue 6(2017:Nov.)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2017-02-16
• Subjects: lead aVR -- positive T wave -- STEMI; Electrocardiography -- Periodicals; Arrhythmia -- Periodicals; 616.1207547
• DOI: 10.1111/anec.12442
• Languages: English
• ISSNs: 1082-720X

Abstract

Abstract : Background: Positive T wave in lead aVR has been shown to predict an adverse in‐hospital outcome in patients with anterior wall ST‐segment elevation myocardial infarction (STEMI). However, the prognostic value of positive T wave in lead aVR on a long‐term outcome has not been fully explored. Methods: We performed a retrospective analysis of 190 consecutive patients with first anterior wall STEMI who underwent an emergent coronary angiogram. Patients were divided into those with positive T wave > 0 mV and those with negative T wave ≦ 0 mV in lead aVR. Baseline and angiographic characteristics, and in‐hospital revascularization procedures were recorded. In addition, in‐hospital and 1‐year major adverse cardiac events (MACE) including death, recurrent myocardial infarction, and target vessel revascularization were recorded. Results: Among 190 patients, 37 patients (19%) had positive T wave and 153 patients (81%) had negative T wave in lead aVR. Patients with positive T wave had higher rate of left main disease defined as stenosis ≥50% (11% vs. 2%, p = .028) than those with negative T wave. Patients with positive T wave had higher rate of 1‐year MACE (38% vs. 13%, p < .001) driven by higher all‐cause mortality (27% vs. 5%, p < .001). Positive T wave was an independent predictor for 1‐year MACE (OR 2.74; 95% CI 1.04–7.15; p = .04). Conclusion: Positive T wave in lead aVR was an independent predictor for 1‐year MACE in patients with first anterior wall STEMI.