Significance of Reciprocal ST-Segment Depression in Inferior Leads During Acute Anterior Myocardial Infarction

We compared the elinical and coronary angiographic features of 126 patients (Group A) with inferior ST-segment depression with 93 patients (Group B) without inferior ST depression during acute anterior myocardial infarction (AMI). Compared with Group B, patients in Group A had higher mean serum peak CPK (1126 vs 888 U/L, p<0.025), and CKMB (85 vs 49 U/L, p<0.005) values, RBBB (9.5 % vs 1.1 %, p<0.01) ventricular tachycardia and fibrillation (15.9 % vs 6.5 %, p<0.05). Coronary angiography was performed in 68 (54 %) patients in Group A within 2.6±1.9 months of AMI and in 49 (53 %) patients in Group B within 2.4±2.3 months. There was no significant difference between the number of coronary artery lesions in the two groups. The site of lesion in left anterior descending artery (LAD) was not significantly different in patients with single- LAD disesase either. We conclude that reciprocal ST-segment depression in inferior leads during acute anterior MI is associated with more extensive infarction and a complicated course.