Automated discrimination of proximal right coronary artery occlusion from middle-to-distal right coronary artery occlusion and left circumflex occlusion in ST-elevation myocardial infarction

Journal of Electrocardiology
Richard E GreggJames M Lindauer

Abstract

Classifying the location of an occlusion in the culprit artery during ST-elevation myocardial infarction (STEMI) is important for risk stratification to optimize treatment. We developed a new logistic regression (LR) algorithm for 3-group classification of occlusion location as proximal right coronary artery (RCA), middle-to-distal RCA or left circumflex (LCx) coronary artery with inferior myocardial infarction. We compared the performance of the new LR algorithm with the recently introduced decision tree classifier of Fiol et al (Ann Noninvasive Electrocardiol. 2004;4:383-388) in the classification of the same 3 categories. The new algorithm was developed on a set of electrocardiograms from an emergency department setting (n = 64) and tested on a different set from a prehospital setting (n = 68). All patients met the current STEMI criteria with angiographic confirmation of culprit artery and occlusion location. Using LR, 4 ST-segment deviation features were chosen by forward stepwise selection. Final LR coefficients were obtained by averaging more than 200 bootstrap iterations on the training set. In addition, a separate 4-feature classifier was designed adding ST features of V4R and V8, only available in the training set. The...Continue Reading

Citations

Feb 14, 2017·The Korean Journal of Internal Medicine·Moo Seong KohJun Young Chung

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