Prognostic value of lead V1 ST elevation during acute inferior myocardial infarction

Circulation
Cheuk-Kit WongHirulog and Early Reperfusion or Occlusion-2 Investigators

Abstract

Lead V(1) directly faces the right ventricle and may exhibit ST elevation during an acute inferior myocardial infarction when the right ventricle is also involved. Leads V(1) and V(3) indirectly face the posterolateral left ventricle, and ST depression ("mirror-image" ST elevation) in V(1) through V(3) may reflect concomitant posterolateral infarction. The prognostic significance of V(1) ST elevation during an acute inferior myocardial infarction may therefore be dependent on V(3) ST changes. In 7967 patients with acute inferior myocardial infarction in the Hirulog and Early Reperfusion or Occlusion-2 (HERO-2) trial, V(1) ST levels were analyzed with adjustment for lead V(3) ST level for predicting 30-day mortality. V(1) ST elevation at baseline, analyzed as a continuous variable, was associated with higher mortality. Unadjusted, each 0.5-mm-step increase in ST level above the isoelectric level was associated with approximately 25% increase in 30-day mortality; this was true whether V(3) ST depression was present or not. The odds ratio for mortality was 1.21 (95% confidence interval, 1.07 to 1.37) after adjustment for inferolateral ST elevation and clinical factors and 1.24 (95% confidence interval, 1.09 to 1.40) if also adjust...Continue Reading

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Jul 5, 2005·Journal of the American College of Cardiology·Cheuk-Kit WongUNKNOWN HERO-2 Trial Investigators
Jun 2, 2010·European Heart Journal·Cheuk-Kit WongUNKNOWN HERO-2 Investigators

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Citations

Aug 23, 2011·European Heart Journal·Cheuk-Kit WongUNKNOWN HERO-2 Investigators
Oct 24, 2012·Current Problems in Cardiology·James A Goldstein
Jul 5, 2015·International Journal of Cardiology·Cheuk-Kit Wong, Harvey D White
Oct 24, 2013·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Shirin ZarafsharV F Froelicher
Apr 28, 2012·Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc·Shlomo Stern
Nov 5, 2013·International Journal of Cardiology·Cheuk-Kit Wong, Harvey D White
May 3, 2016·The American Journal of Emergency Medicine·Nalan KozaciRamazan Guven
May 15, 2013·International Journal of Cardiology·Cheuk-Kit Wong
Oct 9, 2012·International Journal of Cardiology·Cheuk-Kit Wong
Sep 26, 2013·European Heart Journal. Acute Cardiovascular Care·Harvey D WhiteRalph A Stewart
Jan 18, 2020·AACN Advanced Critical Care·Cynthia Webner
Aug 27, 2021·Internal Medicine·Daigo HirayaMasaki Ieda

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