aVR导联ST段抬高在急性冠脉综合征危险分层中的临床意义

目的:分析心电图aVR导联ST段抬高aVR(+)]与临床变量和心肌梗死溶栓(TIMI)危险度评分组合在不稳定心绞痛和非ST段抬高心肌梗死(UA/NSTEMI)的价值与意义.方法:在205例患有UA/NSTEMI的病人中,选择入院心电图aVR(+)超过0.5 mm的进行回顾性评估.结果:入院aVR(+)是30天死亡率有...

Clinical significance of ST-segment elevation in lead aVR to risk stratification in acute coronary syndromes

Objective：To analyze the value and significance of ST elevation in lead aVR aVR（＋）] in initial standard electrocardiogram（ECG） performed on admission in combination with clinical variables and Thrombolysis in Myocardial Infarction（TIMI） Risk Score for unstable angina and non–ST-elevation myocardial infarction（UA/NSTEMI）.Methods：In 205 consecutive patients with UA/NSTEMI,we retrospectively evaluated admission ECG for aVR（＋） more than 0.5 mm.Results：With the use of multivariate analysis,admission aVR（＋） was found to be a strong and independent predictor of 30 d mortality rate.The mortality rate was also increased with the severity of aVR（＋）.In the low-risk groups by clinical factors,those with aVR（＋） had higher death rate than those without aVR（＋） for the patients with negative troponin,heart rate of 110 beats per minute or less,systolic blood pressure greater than 90 mmHg,Killip I class on admission,and aged 70 years or younger,respectively.Compared with the patients without aVR（＋）,the patients with aVR（＋）had higher death rates in the low-and intermediate-risk groups by TIMI risk score.Conclusion：aVR（＋） has important value to the patients with UA/NSTEMI and may provide an additional value to the risk stratification and prognosis,particularly in the patients in the low-risk and intermediate-risk groups.