Switch to
| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
12
|
| pubmed:dateCreated |
1997-7-17
|
| pubmed:abstractText |
In this multicenter prospective trial, we studied posterior (V7 to V9) and right ventricular (V4R to V6R) leads to assess their accuracy compared with standard 12-lead electrocardiograms (ECGs) for the diagnosis of acute myocardial infarction (AMI). Patients aged >34 years with suspected AMI received posterior and right ventricular leads immediately after the initial 12-lead ECG. ST elevation of 0.1 mV in 2 leads was blindly determined and inter-rater reliability estimated. AMI was diagnosed by World Health Organization criteria. The diagnostic value of nonstandard leads was determined when 12-lead ST elevation was absent and present and multivariate stepwise regression analysis was also performed. Of 533 study patients, 64.7% (345 of 533) had AMI and 24.8% received thrombolytic therapy. Posterior and right ventricular leads increased sensitivity for AMI by 8.4% (p = 0.03) but decreased specificity by 7.0% (p = 0.06). The likelihood ratios of a positive test for 12, 12 + posterior, and 12 + right ventricular ECGs were 6.4, 5.6, and 4.5, respectively. Increased AMI rates (positive predictive values) were found when ST elevation was present on 6 nonstandard leads (69.1%), on 12 leads only (88.4%), and on both 6 and 12 leads (96.8%; p <0.001). Treatment rates with thrombolytic therapy increased in parallel with this electrocardiographic gradient. Logistic regression analysis showed that 4 leads were independently predictive of AMI (p <0.001): leads I, II, V3, V5R; V9 approached statistical significance (p = 0.055). The standard ECG is not optimal for detecting ST-segment elevation in AMI, but its accuracy is only modestly improved by the addition of posterior and right ventricular leads.
|
| pubmed:language |
eng
|
| pubmed:journal | |
| pubmed:citationSubset |
AIM
|
| pubmed:status |
MEDLINE
|
| pubmed:month |
Jun
|
| pubmed:issn |
0002-9149
|
| pubmed:author |
pubmed-author:CookeDD,
pubmed-author:FaganJJ,
pubmed-author:FlignerD JDJ,
pubmed-author:HahnK HKH,
pubmed-author:HessionsWW,
pubmed-author:JustinCC,
pubmed-author:KampeL MLM,
pubmed-author:RydmanR JRJ,
pubmed-author:ShahSS,
pubmed-author:SloanE PEP,
pubmed-author:TuckerJJ,
pubmed-author:ZalenskiR JRJ,
pubmed-author:ZwicklMM
|
| pubmed:issnType |
Print
|
| pubmed:day |
15
|
| pubmed:volume |
79
|
| pubmed:owner |
NLM
|
| pubmed:authorsComplete |
Y
|
| pubmed:pagination |
1579-85
|
| pubmed:dateRevised |
2006-11-15
|
| pubmed:meshHeading |
pubmed-meshheading:9202344-Aged,
pubmed-meshheading:9202344-Electrocardiography,
pubmed-meshheading:9202344-Female,
pubmed-meshheading:9202344-Humans,
pubmed-meshheading:9202344-Male,
pubmed-meshheading:9202344-Middle Aged,
pubmed-meshheading:9202344-Multivariate Analysis,
pubmed-meshheading:9202344-Myocardial Infarction,
pubmed-meshheading:9202344-Predictive Value of Tests,
pubmed-meshheading:9202344-Prospective Studies,
pubmed-meshheading:9202344-Reproducibility of Results
|
| pubmed:year |
1997
|
| pubmed:articleTitle |
Value of posterior and right ventricular leads in comparison to the standard 12-lead electrocardiogram in evaluation of ST-segment elevation in suspected acute myocardial infarction.
|
| pubmed:affiliation |
Department of Emergency Medicine, Cook County Hospital, and Center for Health Services Research, School of Public Health, University of Illinois at Chicago 60612, USA.
|
| pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Research Support, Non-U.S. Gov't,
Multicenter Study
|