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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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Date
2015-07-01
Authors
Tusun, Eyyup
Uluganyan, MAHMUT
Ugur, Murat
Karaca, Gurkan
Osman, Faizel
Koroglu, Bayram
Murat, Ahmet
Ekmekci, Ahmet
Uyarel, Huseyin
Sahin, Osman
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Abstract
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.
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Myocardial infarction
Citation
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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