J Korean Soc Emerg Med.  2016 Feb;27(1):43-51. 10.0000/jksem.2016.27.1.43.

Clinical Usefulness of T wave Inversion in Lead aVL of ECG on Acute Coronary Syndrome Patients

• Choi YJ
• Park SO
• Kim JW
• Hong DY
• Lee KR
• Baek KJ
• Kim KS
• Kim SC
• Kim JY

• KMID: 2191636
• DOI: http://doi.org/10.0000/jksem.2016.27.1.43

Abstract

PURPOSE
The aim of the study is to evaluate the clinical usefulness of a TWI in the lead aVL of 12-lead ECG for predicting the left ascending artery (LAD) lesion, high risk, and 30-days mortality in patients with acute coronary syndrome (ACS).
METHODS
A total of 275 patients who underwent coronary angiography under the diagnosis of ACS were analyzed retrospectively from Jan 2012 to December 2013.
RESULTS
A total of 355 patients underwent coronary angiography. Of these, 275 patients (77.5%) were diagnosed with ACS. Of these, 187 patients (68.0%) had a left LAD lesion. Of these, 111 patients (59.3%) had a mid-LAD lesion. Of these, only 23 patients (22.5%) showed a TWI in the aVL lead. However, regarding the prediction of the high risk group, if there is a TWI in the aVL, when compared with patients without a TWI in the aVL, the high risk rate is four times higher in the univariable logistic regression analysis and 2.687 times higher in the multivariable logistic regression analysis.
CONCLUSION
A TWI in the lead aVL of ECG of patients with chest pain in the ER was closely associated with high risk of ACS patients.

Keyword

Electrocardiography; Acute coronary syndrome

MeSH Terms

Acute Coronary Syndrome*
Arteries
Chest Pain
Coronary Angiography
Diagnosis
Electrocardiography*
Humans
Logistic Models
Mortality
Retrospective Studies