Role of ST-segment changes in predicting left anterior descending branch occlusion in elderly patients with anterior AMI

doi:10.3969/j.issn.1009-0126.2015.11.012

Abstract：Objective To study the role of ST‐segment changes in predicting left anterior descend‐ing (LAD) branch occlusion in elderly patients with anterior AMI .Methods LAD branch occlu‐sion in 306 elederlty anterior AMI patients admitted to our hospital from June 2010 to March 2015 was predicted according to their ST‐segment changes on the lateral and inferior leads and com‐pared with the occlusion detected by coronary arteriography .The coronary artery was divided into proximal and distal segments according to the large diagonal (LD ) or the first diagonal (D1 ) . Results The ST‐segment elevation was >0 .1 mV in 96 (31 .4% )and depression ≥0 .1 mV in 92 (30 .1% ) out of the 306 anterior elderly AMI patients .NO significant difference was found in the sensitivity of ST‐segment elevation>0 .1 mV or depression≥0 .1 mV to identify the LAD occlu‐sion (61 .2% vs 62 .7% ,65 .3% vs 64 .2% ) ,LAD was bounded either D1 or LD .The specificity of boundary as D1 was significantly lower than that of boundary as LD to identify the LAD occlusion (82 .7% vs 93% ,P=0 .003 ,86 .5% vs 96 .5% ,P=0 .001) ,ST‐segment either elevation>0 .1 mV or depression≥0 .1 mV .The positive predictive value of boundary as D1 was significantly lower than that of boundary as LD to identify the LAD occlusion (62 .5% vs 87 .5% ,P= 0 .000 , 69 .6% vs 93 .5% ,P= 0 .000) ,ST‐segment either elevation>0 .1 mV or depression≥0 .1 mV . Conclusion LAD occlusion usually occurs in the proximal LD according to the ST‐segment eleva‐tion in elderly anterior AMI patients .