ST-Segment Elevation of Right Precordial Lead (V4R) Is Associated with Multivessel Disease and Increased In-Hospital Mortality in Acute Anterior Myocardial Infarction Patients
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Background: ST segment elevation of chest lead V4 R is associated with worse prognosis in acute inferior ST-elevation myocardial infarction (STEMI). This study tried to determine the relationship between ST elevation in the right precordial lead V4 R and acute anterior STEMI. Methods: Prospective study of 144 consecutive anterior STEMI patients: all had 15-lead ECG recordings (12 conventional leads and V3 R-V5 R) obtained. Patients were classified into two groups on the basis of presence (Group I, 50 patients) or absence (Group II, 94 patients) of ST-segment elevation ≥0.5 mm in lead V4 R. Results: Multivessel involvement was significantly higher in Group I compared with Group II (54% and 23% respectively, P < 0.001). Major adverse cardiac events and in-hospital mortality was also significantly higher for those in Group I (P < 0.02 for both). A significant correlation was found between in-hospital mortality and those in Group I (P = 0.03, OR: 6.27, CI: 1.22-32.3). There was an independent relationship between in-hospital mortality and V4 R-ST elevation (P = 0.03, OR: 11.64, CI: 1.3-27.4). Conclusion: ST segment elevation in chest lead V4 R is associated with multivessel disease and increased in-hospital mortality in patients with anterior STEMI that had undergone primary percutaneous coronary intervention to the left anterior descending artery.
Tusun E., Uluganyan M., Ugur M., Karaca G., Osman F., Koroglu B., Murat A., Ekmekci A., Uyarel H., Sahin O., et al., -ST-Segment Elevation of Right Precordial Lead (V4R) Is Associated with Multivessel Disease and Increased In-Hospital Mortality in Acute Anterior Myocardial Infarction Patients-, ANNALS OF NONINVASIVE ELECTROCARDIOLOGY, cilt.20, ss.362-367, 2015
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