Clinical Investigations: ElectrophysiologyClinical significance of ST-segment elevation in lead V1 in patients with acute inferior wall Q-wave myocardial infarction☆
Section snippets
Patients
We studied 158 consecutive patients (aged 37 to 86 years) with their first Q-wave inferior wall myocardial infarction who had coronary angiography on admission to have direct percutaneous transluminal coronary angioplasty between February 1988 and August 1997. Inclusion criteria were (1) admission to the coronary care unit <12 hours from the onset of chest pain, (2) no prior history of myocardial infarction or chronic lung disease, and (3) sinus rhythm without intraventricular conduction
Clinical characteristics (Table I)
Group 1, Patients with ST elevation in V1; group 2, patients with ST depression in V1; group 3, patients with no ST change in V1.Empty Cell Group 1 (n = 29) Group 2 (n = 97) Group 3 (n = 32) P value Age (y) 61 ± 13 64 ± 11 64 ± 11 .496 Men/women 21/8 70/27 22/10 .927 Hypertension 12 (41%) 43 (44%) 11 (34%) .612 Diabetes mellitus 11 (38%) 38 (39%) 9 (28%) .525 Hypercholesterolemia 9 (31%) 27 (28%) 11 (34%) .771 Cigarette smoking 16 (55%) 49 (51%) 19 (59%) .665 Time to reperfusion (h) 5.3 ± 2.3 4.6 ± 2.2 5.3 ± 2.4 .066
Discussion
The patients with inferior wall myocardial infarction are a heterogeneous group, dependent on whether posterior left ventricular segments or the right ventricle are also involved. Therefore the ability to identify high-risk subgroups by the admission electrocardiogram is necessary to estimate the severity of myocardial infarction.1, 2, 3, 4, 5, 6, 7 Moreover, because nearly half the incidences of inferior wall myocardial infarction with total occlusion of the proximal right coronary artery are
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Reprint requests: Tetsuro Sugiura, MD, Department of Clinical Laboratory Medicine, Kochi Medical School, Kohasu Oko-cho Nankoku City, Kochi, Japan 783-8505. E-mail:[email protected]