Misumida Naoki, Kobayashi Akihiro, Aoi Shunsuke, Fox John T, Schweitzer Paul, Kanei Yumiko
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
Department of Internal Medicine, Mount Sinai Beth Israel, NY, USA.
J Electrocardiol. 2015 Nov-Dec;48(6):1022-6. doi: 10.1016/j.jelectrocard.2015.08.011. Epub 2015 Aug 4.
The prognostic value of ST-segment elevation in lead V1 (STE in V1) in anterior ST-segment elevation myocardial infarction (STEMI) has not been elucidated.
We performed a retrospective analysis of 190 consecutive first anterior STEMI patients. STE in V1 ≥0.1mV was recorded. Major adverse cardiac events (MACE) were defined as a composite of all-cause death, recurrent myocardial infarction, or target vessel revascularization.
Among 190 patients, 42 patients did not have STE in V1. The patient without STE in V1 had a higher peak creatine kinase value and a higher incidence of 1-year MACE (36% vs. 13%, p<0.001), driven by a higher mortality (24% vs. 5%, p<0.001). The absence of STE in V1 was an independent predictor for 1-year MACE (odds ratio 3.16; 95% confidence interval 1.28-7.83; p=0.01).
The absence of STE in V1 was an independent predictor for worse long-term outcomes in patients with first anterior STEMI.
前壁ST段抬高型心肌梗死（STEMI）患者中，V1导联ST段抬高（V1导联STE）的预后价值尚未阐明。
我们对190例连续的首次前壁STEMI患者进行了回顾性分析。记录V1导联STE≥0.1mV的情况。主要不良心脏事件（MACE）定义为全因死亡、再发心肌梗死或靶血管血运重建的复合事件。
190例患者中，42例患者V1导联无STE。V1导联无STE的患者肌酸激酶峰值更高，1年MACE发生率更高（36%对13%，p<0.001），这是由更高的死亡率（24%对5%，p<0.001）导致的。V1导联无STE是1年MACE的独立预测因素（比值比3.16；95%置信区间1.28 - 7.83；p = 0.01）。
V1导联无STE是首次前壁STEMI患者长期预后较差的独立预测因素。
