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document
Prediction of the infarct-related artery in acute myocardial infarction by a scoring system using summary ST-segment and T-wave changes . We developed a scoring system to predict the artery responsible for an acute myocardial infarction ( AMI ) using ST-segment and T-wave changes on the initial electrocardiogram ( ECG ) using data from 228 patients ( development set ) with symptoms compatible with AMI and tested in a similar group of 223 patients ( test set ) from the Thrombolysis and Angioplasty in Myocardial Infarction ( TAMI-5 ) Trial . Using stepwise logistic regression we were able to accurately predict the left anterior descending ( LAD ) , right , or left circumflex ( LC ) coronary artery as the infarct-related artery using 2 variables : ( 1 ) the summation of the ST-segment elevation in leads V1 to V4 ; and ( 2 ) the summation of the T-wave negativity in leads I , aVL , and V5 . In the development set , these 2 variables demonstrated respective sensitivity and specificity of 98 % and 90 % for LAD lesions , 82 % and 85 % for right narrowings , and 82 % and 84 % for LC narrowings . In the test set , the sensitivity and specificity were 97 % and 95 % for LAD lesions , 85 % and 86 % for right lesions , and 73 % and 60 % for LC coronary artery lesions . Information easily obtained on the ECG can accurately predict the likelihood of the LAD , right , or LC artery as the infarct-related artery . This may be useful in the decision to administer thrombolytic treatment .
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Intervention_Physical
summary ST-segment and T-wave changes
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Intervention_Physical
ST-segment and T-wave changes
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Intervention_Surgical
initial electrocardiogram ( ECG )
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Outcome_Other
sensitivity and specificity
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Outcome_Other
sensitivity and specificity
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Outcome_Physical
LC coronary artery lesions
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Participant_Sample-size
228
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Participant_Condition
AMI
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Participant_Sample-size
223