Association of electrocardiographic changes with severity of coronary artery disease and short term outcome in patients with non-ST-segment elevation acute coronary syndromes

ABSTRACT

To assess the association between electrocardiogram [ECG] changes in non-ST-segment elevation acute coronary syndrome [NSTE-ACS] patients with severity of coronary artery disease [CAD] and short-term outcome. In this cross-sectional descriptive -analytical study, 111 patients admitted to the Cardiology Department of Shahid Madani Heart Hospital, Tabriz, Iran between March 2005 and March 2007 with first NSTE-ACS, and had undergone coronary angiography during index event were evaluated. One hundred and eleven patients [64 males, and 47 females] were enrolled, and their in-hospital and short-term outcome with a mean follow-up period 4.6 +/- 1.8 months was evaluated. Patients with ST-T changes on admission had higher rates of death [16.7 versus 2.7%, p=0.01], recurrent angina [36.1 versus 6.7%, p=0.001], and pulmonary edema [8.3 versus 1.3%, p=0.045]. The mean left ventricular ejection fraction [LVEF] of patients with ECG changes were significantly lower than those without ECG changes [p=0.001]. Mitral regurgitatio [MR] was also common among those with ECG changes [p=0.006]. In a multivariate regression analysis, the only independent predictor of short-term mortality and adverse clinical event was ST depression on ECG [p=0.001]. In patients with first NSTE-ACS, ST deviation is associated with adverse short-term outcome including more severe CAD, lower LVEF, and more common MR