急性冠状动脉综合征患者aVR导联st段改变与血管造影结果、句法评分、短期和中期预后之间的关系:一项初步研究

IF 0.5 Q4 CARDIAC & CARDIOVASCULAR SYSTEMS ARYA Atherosclerosis Pub Date : 2024-01-01 DOI:10.48305/arya.2024.42601.2954
Afshin Amirpour, Hosein Masoumi, Masoumeh Sadeghi, Reihaneh Zavar, Bahar Darouei, Seyedeh Mahnaz Mirbod, Raza Amani-Beni
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引用次数: 0

摘要

背景:在本研究中,我们旨在探讨急性冠脉综合征(ACS)患者初始心电图(ECG) aVR导联st段抬高对预后的影响。此外,我们评估了aVR导联心电图变化与客观指标(如血管造影结果和句法评分)之间的关系。方法:这项回顾性队列研究是一项试点研究,包括回顾性横断面分析和纵向随访,于2017年11月至2019年10月在Chamran医院进行。通过电话访谈进行了为期6个月的随访以评估患者的预后。结果:研究期间,76例最终诊断为急性冠状动脉综合征,心电图aVR导联st段抬高。在STE-aVR≥1.5 mm的患者中,ARB摄入量和右冠状动脉狭窄的严重程度明显更高。aVR导联st段变化的临床通路分析和6个月随访结果显示,各种干预策略和临床事件的分布无统计学差异。总st段改变是6个月随访血管造影的重要危险因素(OR: 1.10;95% CI: 1.002至1.213),并且与RCA区域的任何狭窄也显著相关(OR: 1.10;95% CI: 1.004 ~ 1.21)。st段改变与其他随访医院和血管造影结果之间无显著关联。结论:研究结果提示,用药史,特别是血管紧张素受体阻滞剂,可能影响aVR导联st段的变化。然而,需要进一步的研究来更好地了解这些趋势的临床意义。
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Association between ST-segment changes in lead aVR and angiographic findings, syntax score, short-term and intermediate outcomes in patients with acute coronary syndrome: A pilot study.

Background: In this study, we aimed to investigate the prognostic implications of lead aVR ST-segment elevation in an initial electrocardiogram (ECG) in patients diagnosed with acute coronary syndrome (ACS). Furthermore, we evaluated the association between electrocardiographic changes in lead aVR and objective measures such as angiographic findings and Syntax score.

Methods: This retrospective cohort study, conducted as a pilot study, encompassing both a retrospective cross-sectional analysis and a longitudinal follow-up, took place at Chamran Hospital from November 2017 to October 2019. A 6-month follow-up was conducted via phone interviews to assess patient outcomes.

Results: During the study period, there were 76 admissions with the final diagnosis of acute coronary syndrome and lead aVR ST-segment elevation on ECG. ARB intake and the severity of right coronary artery stenosis were significantly higher in patients with STE-aVR ≥1.5 mm. The clinical pathway analysis and 6-month follow-up outcomes concerning ST-segment changes in lead aVR did not reveal statistically significant differences in the distribution of various intervention strategies and clinical events. The overall ST-change was a significant risk factor for 6-month follow-up angiography (OR: 1.10; 95% CI: 1.002 to 1.213) and was also significantly associated with any stenosis in the RCA territory (OR: 1.10; 95% CI: 1.004 to 1.21). There was no significant association between ST-change and other follow-up hospital and angiography outcomes.

Conclusion: The findings suggest that medication history, particularly with angiotensin receptor blockers, may shape the observed ST-segment changes in lead aVR. However, further investigation is needed to better understand the clinical implications of these trends.

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来源期刊
ARYA Atherosclerosis
ARYA Atherosclerosis CARDIAC & CARDIOVASCULAR SYSTEMS-
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审稿时长
18 weeks
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