Predictors of left main or three-vessel disease in patients who have acute coronary syndromes with non-ST-segment elevation

被引:75
作者
Kosuge, M [1 ]
Kimura, K [1 ]
Ishikawa, T [1 ]
Ebina, T [1 ]
Shimizu, T [1 ]
Hibi, K [1 ]
Toda, N [1 ]
Tahara, Y [1 ]
Tsukahara, K [1 ]
Kanna, M [1 ]
Okuda, J [1 ]
Nozawa, N [1 ]
Ozaki, H [1 ]
Yano, H [1 ]
Umemura, S [1 ]
机构
[1] Yokohama City Univ, Med Ctr, Div Cardiol, Minami Ku, Yokohama, Kanagawa 2320024, Japan
关键词
D O I
10.1016/j.amjcard.2005.01.085
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
To identify an early, simple, noninvasive predictor of left main (LM) or 3-vessel disease (3-VD), we retrospectively studied clinical variables on admission in 310 patients with acute coronary syndromes with non-ST-segment elevation. Univariate analysis indicated that many factors were related to LM/3-VD. Multivariate analysis showed that ST-segment elevation in lead aVR of >= 0.5 mm was the strongest predictor of LM/3-VD, followed by positive troponin T (odds ratio 19.7, p < 0.001, and odds ratio 3.08, p = 0.048, respectively). ST-segment elevation in lead aVR of >= 0.5 mm and positive troponin T identified LM/3-VD with sensitivities of 78% and 62%, specificities of 86% and 59%, positive predictive values of 57% and 26%, and negative predictive values of 95% and 87%, respectively (p < 0.05). Our findings suggest that in patients with non-ST-segment elevation acute coronary syndromes, ST-segment elevation in lead aVR of >= 0.5 mm and positive troponin T on admission (especially the former) are useful predictors of LM/3-VD. (c) 2005 by Excerpta Medica Inc.
引用
收藏
页码:1366 / 1369
页数:4
相关论文
共 15 条
[1]   Prognostic value of lead aVR in patients with a first non-ST-segment elevation acute myocardial infarction [J].
Barrabés, JA ;
Figueras, J ;
Moure, C ;
Cortadellas, J ;
Soler-Soler, J .
CIRCULATION, 2003, 108 (07) :814-819
[2]   ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-Segment elevation myocardial infarction - Summary article - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina) [J].
Braunwald, E ;
Antman, EM ;
Beasley, JW ;
Califf, RM ;
Cheitlin, MD ;
Hochman, JS ;
Jones, RH ;
Kereiakes, D ;
Kupersmith, J ;
Levin, TN ;
Pepine, CJ ;
Schaeffer, JW ;
Smith, EE ;
Steward, DE ;
Theroux, P ;
Gibbons, RJ ;
Alpert, JS ;
Faxon, DP ;
Fuster, V ;
Gregoratos, G ;
Hiratzka, LF ;
Jacobs, AK ;
Smith, SC .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 40 (07) :1366-1374
[3]   Benefit of clopidogrel in patients with acute coronary syndromes without ST-segment elevation in various risk groups [J].
Budaj, A ;
Yusuf, S ;
Mehta, SR ;
Fox, KAA ;
Tognoni, G ;
Zhao, F ;
Chrolavicius, S ;
Hunt, D ;
Keltai, M ;
Franzosi, MG .
CIRCULATION, 2002, 106 (13) :1622-1626
[4]   The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q wave myocardial infarction: Results of the TIMI III registry ECG ancillary study [J].
Cannon, CP ;
McCabe, CH ;
Stone, PH ;
Rogers, WJ ;
Schactman, M ;
Thompson, BW ;
Pearce, DJ ;
Diver, DJ ;
Kells, C ;
Feldman, T ;
Williams, M ;
Gibson, RS ;
Kronenberg, MW ;
Ganz, LI ;
Anderson, HV ;
Braunwald, E .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1997, 30 (01) :133-140
[5]   USEFULNESS OF ST-SEGMENT CHANGES IN GREATER-THAN-OR-EQUAL-TO-2 LEADS ON THE EMERGENCY ROOM ELECTROCARDIOGRAM IN EITHER UNSTABLE ANGINA-PECTORIS OR NON-Q-WAVE MYOCARDIAL-INFARCTION IN PREDICTING OUTCOME [J].
COHEN, M ;
HAWKINS, L ;
GREENBERG, S ;
FUSTER, V .
AMERICAN JOURNAL OF CARDIOLOGY, 1991, 67 (16) :1368-1373
[6]   Cardiac troponin T in chest pain unit patients without ischemic electrocardiographic changes: Angiographic correlates and long-term clinical outcomes [J].
deFilippi, CR ;
Tocchi, P ;
Parmar, RJ ;
Rosanio, S ;
Abreo, G ;
Potter, MA ;
Runge, MS ;
Uretsky, BF .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 35 (07) :1827-1834
[7]   Angiographic correlates of a positive troponin T test in patients with unstable angina [J].
Frey, N ;
Dietz, A ;
Kurowski, V ;
Giannitsis, E ;
Tölg, R ;
Wiegand, U ;
Richardt, G ;
Katus, HA .
CRITICAL CARE MEDICINE, 2001, 29 (06) :1130-1136
[8]   Angiographic findings in patients with refractory unstable angina according to troponin T status [J].
Heeschen, C ;
van den Brand, MJ ;
Hamm, CW ;
Simoons, ML .
CIRCULATION, 1999, 100 (14) :1509-1514
[9]   The effect of clopidogrel in combination with aspirin when given before coronary artery bypass grafting [J].
Hongo, RH ;
Ley, J ;
Dick, SE ;
Yee, RR .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 40 (02) :231-237
[10]   Coronary angiographic findings and troponin T in patients with unstable angina pectoris [J].
Jurlander, B ;
Farhi, ER ;
Banas, JJ ;
Keany, CM ;
Balu, D ;
Grande, P ;
Ellis, AK .
AMERICAN JOURNAL OF CARDIOLOGY, 2000, 85 (07) :810-814