ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients

Natalia Gołąbek; Wojciech Jakubowski; Szymon Król; Mateusz Kozioł; Łukasz Niewiara; Paweł Kleczyński; Jacek Legutko; Artur Dziewierz; Andrzej Surdacki; Michał Chyrchel

doi:10.5114/aic.2023.132161

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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4/2023
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abstract:

Original paper

ECG patterns suggestive of high-risk coronary anatomy in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients

Natalia Gołąbek

¹

,

Wojciech Jakubowski

¹

,

Szymon Król

²

,

Mateusz Kozioł

²

,

Łukasz Niewiara

³

,

Paweł Kleczyński

³

,

Jacek Legutko

³

,

Artur Dziewierz

⁴

,

Andrzej Surdacki

⁴

,

Michał Chyrchel

⁴

Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Students’ Scientific Group of Modern Cardiac Therapy at the Department of Interventional Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
Department of Interventional Cardiology, Institute of Cardiology, Jagiellonian University Medical College, John Paul II Hospital, Krakow, Poland
Second Department of Cardiology, Institute of Cardiology, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland

Adv Interv Cardiol 2023; 19, 4 (74): 326–332

DOI: https://doi.org/10.5114/aic.2023.132161

Online publish date: 2023/10/18

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AMA

Gołąbek N, Jakubowski W, Król S, et al. ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2023;19(4):326-332. doi:10.5114/aic.2023.132161.

APA

Gołąbek, N., Jakubowski, W., Król, S., Kozioł, M., Niewiara, Ł.,  & Kleczyński, P. et al. (2023). ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 19(4), 326-332. https://doi.org/10.5114/aic.2023.132161

Chicago

Gołąbek, Natalia, Wojciech Jakubowski, Szymon Król, Mateusz Kozioł, Łukasz Niewiara, Paweł Kleczyński,  and Jacek Legutko et al. 2023. "ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 19 (4): 326-332. doi:10.5114/aic.2023.132161.

Harvard

Gołąbek, N., Jakubowski, W., Król, S., Kozioł, M., Niewiara, Ł., Kleczyński, P., Legutko, J., Dziewierz, A., Surdacki, A.,  and Chyrchel, M. (2023). ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 19(4), pp.326-332. https://doi.org/10.5114/aic.2023.132161

MLA

Gołąbek, Natalia et al. "ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 19, no. 4, 2023, pp. 326-332. doi:10.5114/aic.2023.132161.

Vancouver

Gołąbek N, Jakubowski W, Król S, Kozioł M, Niewiara Ł, Kleczyński P et al. ECG patterns suggestive of high-risk coronary anatomy  in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2023;19(4):326-332. doi:10.5114/aic.2023.132161.

Introduction:
Electrocardiographic (ECG) patterns suggestive of high-risk coronary anatomy are indications for an urgent invasive approach in non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

Material and methods:
Out of 207 pre-screened subjects diagnosed with NSTE-ACS, 64 patients (26 women and 38 men) with complete medical records (including admission ECG and coronary angiography during the index hospitalization), and significant culprit stenosis or occlusion of the left main coronary artery (LMCA) or the proximal/middle segment of the left anterior descending artery (LAD) entered the final analysis. Clinical characteristics of patients exhibiting any of the high-risk ECG patterns was compared to their counterparts with significant lesions in LMCA or proximal/middle LAD without any of the high-risk ECG patterns.

Results:
Among 64 patients with significant culprit lesions in LMCA or LAD, 19 (29.69%) exhibited one of the high-risk ECG patterns: Wellens syndrome (n = 10), the de Winter sign (n = 0), or multiple ST-segment depressions (n = 9). Clinical characteristics were comparable in 19 NSTE-ACS patients with the high-risk ECG patterns and their 45 counterparts.

Conclusions:
Because ECG patterns suggestive of high-risk coronary anatomy are relatively frequent in patients with NSTE-ACS and culprit lesions in LMCA or LAD, their early recognition is of clinical importance.

keywords:

ECG patterns suggestive of high-risk coronary anatomy in non-ST-segment elevation acute coronary syndrome – an analysis of real-world patients

Natalia Gołąbek 1 , Wojciech Jakubowski 1 , Szymon Król 2 , Mateusz Kozioł 2 , Łukasz Niewiara 3 , Paweł Kleczyński 3 , Jacek Legutko 3 , Artur Dziewierz 4 , Andrzej Surdacki 4 , Michał Chyrchel 4

aVR ST-segment elevation, non-ST-segment elevation acute coronary syndrome, ST-elevation myocardial infarction equivalents, Wellens syndrome

Natalia Gołąbek

¹

,

Wojciech Jakubowski

¹

,

Szymon Król

²

,

Mateusz Kozioł

²

,

Łukasz Niewiara

³

,

Paweł Kleczyński

³

,

Jacek Legutko

³

,

Artur Dziewierz

⁴

,

Andrzej Surdacki

⁴

,

Michał Chyrchel

⁴