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Subject Area

Parasitology

Article Type

Review

Abstract

Background Early prediction of the site and proximity of the occlusion in the culprit artery is essential from a clinical point of view. Objective This study aimed to assess the accuracy of previously defined ECG criteria determined from ECG angiographic correlative studies in predicting not only the infarct-related artery but also the site of the culprit lesion within that artery. Patients and methods ECG and angiographic findings were correlated in 187 patients with an ST-segment elevation myocardial infarction (STEMI). Results In the first group (Anterior ST elevation Myocardial infarction; STEMI), ECG criteria that predict the angiographic findings showed sensitivity and specificity of 55.6% and 100% respectively with 100 % PPV and 80% NPV in subgroup 1 (occlusion proximal to the first diagonal branch; D1). While in subgroup II (occlusion distal to D1), the sensitivity and specificity of the ECG criteria scored 84.4% and 100 % respectively with 100% PPV and 78.3% NPV Whereas in the second group (Inferior STEMI), The sensitivity of the ECG criteria to predict Right Coronary artery (RCA) as the culprit artery was 76.92% and its specificity was 100% with 100% PPV and 92.5 NPV. While to predict Left circumference Artery (LCX) as the culprit artery, the sensitivity and specificity were 100% and 76.92 % respectively with 92.5% PPV and 100% NPV. Conclusion This sequential ECG algorithm based on ST-segment deviations in different leads allowed us to predict the location of occlusion with good accuracy. We recommend the use of the algorithm in everyday clinical practice.

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