Usefulness of the Adminission Electrocardiogram for Identifying the Multi-vessel Disease in Anterior and Anterior-inferior Acute Myocardial Infarction

This study compares the initial ECG with coronary angiographic findings in patients having electrocardiographic criteria for either an anterior AMI or anterior-inferior AMİ in order to determine whether the initial ECG can predict the IRA and whether the extent of coronary artery disease randers the ability to predict the culprit artery. Over a 3-year period, 86 patients met electrocardiographic criteria for anterior wall AMI (:2:1 mm ST,segment elevation at least two leads among leads V ı to V 6). Patients who underwent coronary angiography within 14 days of infaretion with unequivocal culprit lesion were included. The number of vessels with :2:50% luminal stenosis was recorded. Patients were divided into 2 groups based on whether the IRA was LAD or ınultivessed disease involving LAD. LAD+Cx or LAD+RCA or LAD+RCA+Cx). The patients with anteri or AMI w ere as sessed according to :2:0. 1 m V ST elevation or depression at least in two leads Dil, Dili, and a VF (as anterior-inferior AMI or inferi or reciprocal changes). All patients with anterior AMI were also assessed as only one group, irrespective of ST-segment elevation or depression in inferior leads. ST-segment depression in lead aVL (p:0.017) and V6 (p:O.Ol) were found significantly showing multivessel disease in patients with anterior AMI with inferior reciprocal changes. There was no difference between LAD or multivessel disease in patients with anterior-inferior AMI. ST-segment depression in lead I, aVL, V4, VS, and V6 were found statistically significant showing multivessel disease in patients with all anterior AMI irrespective of inferior ST changes (p:0.04, p:0.03, p:0.02, p:0.04, p:0.0009, respectively). In conclusion, on patients presenting with electrocardiographic criteria for an anteri or w all AMI with inferi or ST -segment depression, the presence of concomitant anterol ateral ST depression was a useful electrocardiographic criteria to predict multi-vessel disease.