Prediction of culprit artery from ECG in acute ST elevation myocardial infarction and correlating with coronary angiography

Abstract

Acute myocardial infarction (AMI) is one of the most common diagnoses in hospitalized patients in industrialized countries. The early (30-day) mortality rate from AMI is ~30%, with more than half of these deaths occurring before the stricken individual reaches the hospital.When patients present with acute coronary syndrome, The 12-lead electrocardiogram (ECG) recorded by the alarmed general practitioner or ambulance staff is a pivotal diagnostic and triage tool since it is at the center of the decision pathway for management. In this study the accuracy of ECG in identifying the culprit artery was determined by comparing ECG finding with angiography finding which is a direct visualization procedure.To assess the value of electrocardiogram in predicting the culprit artery in acute ST elevation MI and correlating with coronary angiogram finding. A Cross Sectional Observational study was carried out for a period of 11months from February 2021 to December 2021 among 100 Patients admitted to ICCU, Dept of Cardiology, King George Hospital, Visakhapatnam who were diagnosed with acute ST-elevation myocardial infarction. The accuracy of ECG in identifying the culprit artery was determined by comparing ECG finding with angiography finding which is a direct visualization procedure. The sensitivity of ECG in predicting LAD as infarct related artery when compared to CAG, which was taken as standard test is 94.10%, specificity 89.79% the positive predictive value is 90.56% and the negative predictive value is 93.61%. In the present study, ECG well correlated with CAG (90.56%) in predicting LAD as infarct related artery.