Effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome / 中国基层医药

ABSTRACT

Objective To investigate the effect of lead aVR on recent prognosis in patients with non -ST -elevation acutecoronary syndrome(NSTE -ACS).Methods 195 patients with NSTE -ACS were divided into ST segment elevation in lead aVR group(n =54 cases)and non -ST segment elevation in lead aVR group(n =141 ) according to ST segment elevation in lead on admission;clinical data,laboratory index and coronary artery lesion were recorded,and major adverse cardiac (MACE)in hospitalization time were also recorded.Results Compared with non -ST segment elevation in the lead aVR group,the heart rate of ST segment elevation in the lead aVR group was faster[(85.4 ±12.0)beats per minute vs.(79.3 ±13.2)beats per minute,t =2.959,P <0.05],systolic blood pressure and diastolic blood pressure were higher[(145.0 ±20.3)mmHg vs.(136.0 ±19.4)mmHg,t =2.874,P <0.05];NT -proBNP[(743.9 ±125.8)pg/mL vs.(416.4 ±95.3)pg/mL,t =19.625,P <0.05],cTnI[(3.4 ± 1.0)ng/mL vs.(1.2 ±0.4)ng/mL,t =21.994,P <0.05],CK -MB[(31.5 ±9.8)ng/mL vs.(19.8 ±6.5)ng/mL, t =9.682,P <0.05]were higher (P <0.05);LVEF were lower[(50.1 ±5.2)% vs.(53.8 ±5.7)%,t =4.153, P <0.05];the rate and amplitude of low ST segment in outside lead aVR also was higher[(9.5 ±3.8)mm vs. (7.4 ±2.8)mm,t =4.224,P <0.05];the rate of left main and three -vessel disease in ST segment elevation in lead aVR group were higher (P <0.05).Compared with non -MECE group,proportion of ST segment elevation in lead AVR on admission was higher (P <0.05).Logistic regression analysis showed that heart rate(OR =1.472),NT -proBNP(OR =1.732),cTnI(OR =1.893),left main coronary artery(OR =2.478)and three -vessel disease (OR =2.310)were risk for ST segment elevation in lead AVR(P <0.05).Logistic regression analysis also showed that ST segment elevation in lead AVR were risk for MACE(OR =1.474).Conclusion ST segment elevation in lead AVR has close relationship with large area of myocardial ischemia,and patients prognosis is poorer,which may be independ-ent risk factor for the recent outcomes of patients with NSTE -ACS.Early record of the change in the case of aVR lead ECG ST segment NSTE -ACS patients is of important value in evaluation of the condition and prognosis.