Abstract：ObjectiveTo investigate the predictive value of ST-segment elevation in aVR lead combined with low voltage in aVF lead on left main and(or) threevessel lesion in patients with non-ST-segment elevation acute coronary syndrome(NST-ACS). MethodsRetrospective analysis was performed on the basic data, angiographic results and the first electrocardiogram(ECG) of 132 NST-ACS patients who had been treated in our hospital from December 2017 to December 2018. According to the angiographic results, the enrolled patients were divided into group A\[with left main and(or) threevessel lesion\] and group B\[without left main and(or) threevessel lesion\]. The diagnostic efficiency of STsegment elevation in aVR lead and low voltage in aVF lead for left main and(or) threevessel lesion was analyzed. ResultsThe proportion of patients with ACS, and diabetes or smoking histories in group A was higher than that in group B, with statistically significant differences(P<0.05); the proportion of patients with ST-segment elevation in aVR lead or low voltage in aVF lead in group A was significantly higher than that in group B(61.76% vs 40.82%, 55.88% vs 35.71%), with statistically significant differences(P<0.05). In the diagnosis of left main and(or) threevessel lesion, the Yoden index of ST-segment elevation in aVR lead and low voltage in aVF lead was 20.94% and 20.17%, respectively. The specificity, positive predictive value and Yoden index of the joint index were all higher than those of either of the two indexes, and the differences were statistically significant(P<0.05). For ST-segment elevation in aVR lead, low voltage in aVF lead and the joint predictor, the area under ROC curve was separately 0.626, 0.666 and 0.722, with statistically significant differences(P<0.05). ConclusionThe specificity of ST-segment elevation in aVR lead combined with low voltage in aVF lead is relatively high in diagnosing left main and(or) threevessel lesion. The joint index proves to have great diagnostic value in an early phase.
唐品升, 杨海玉, 束明慧, 于涛, 刘冠英. 加压肢体导联对非ST段抬高型急性冠脉综合征患者左主干和/或3支病变的预测价值[J]. 实用心电学杂志, 2019, 28(3): 183-187.
TANG Pin-Sheng, YANG Hai-Yu, SHU Ming-Hui, YU Tao, LIU Guan-Ying. Predictive value of augmented limb leads for left main and(or) threevessel lesion in patients with non-ST-segment elevation acute coronary syndrome. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2019, 28(3): 183-187.
2019, Vol. 28 
