Circulation Reports
Online ISSN : 2434-0790
Ischemic Heart Disease
Acute Left Circumflex Coronary Artery Occlusion　― Diagnostic Problems of Initial Electrocardiographic Changes ―
Junya Komatsu, Yu-ki Nishimura, Hiroki Sugane, Hayato Hosoda, Ryu-ichiro Imai, Yoko Nakaoka, Koji Nishida, Shu-ichi Seki, Toru Kubo, Naohito Yamasaki, Hiroaki Kitaoka, Sho-ichi Kubokawa, Kazuya Kawai, Naohisa Hamashige, Yoshinori Doi
Author information
Keywords: Acute circumflex coronary artery occlusion, Diagnostic problems, Door-to-balloon time, No ST-segment changes
JOURNAL OPEN ACCESS FULL-TEXT HTML

2022 Volume 4 Issue 10 Pages 482-489

Browse “Advance online publication” version
Details
Full-text HTML Download PDF (1437K)
Download citation RIS

(compatible with EndNote, Reference Manager, ProCite, RefWorks)

BIB TEX

(compatible with BibDesk, LaTeX)

Text
How to download citation
Contact us
Abstract

Background: Acute coronary syndrome (ACS) with occlusion of the left circumflex coronary artery (LCX) poses diagnostic problems that may lead to a delay in reperfusion.

Methods and Results: From a group of 1,269 consecutive patients with ACS, 138 patients with ACS due to LCX occlusion were analyzed for clinical, electrocardiographic, and angiographic presentations, as well as door-to-balloon (DTB) time. Electrocardiographic changes were classified into 4 patterns: ST-segment elevation in inferior/lateral leads (ST-E); ST-segment depression in V1–V4 (ST-D); no significant ST changes (No-ST); and others. The No-ST group was associated with a longer DTB time (P<0.0001) compared with the ST-E and ST-D groups. Compared with the No-ST and ST-E groups, the ST-D group presented with a more advanced Killip class (P=0.003), greater peak creatine phosphokinase (P=0.007) and peak creatine kinase-MB (P=0.006), more frequent proximal LCX occlusion (P=0.007), and worse 1-year outcomes (P=0.0034).

Conclusions: One-third of ACS patients with LCX occlusion showed no ST-segment changes, resulting in significantly longer DTB time. Improving diagnostic accuracy is challenging but critical to avoid delayed reperfusion in these patients without electrocardiographic changes.

Content from these authors
© 2022, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
Previous article Next article
Favorites & Alerts

Recently viewed articles
Related journals
Circulation Journal
Share this page
feedback
 Top