• NEWS . 30 Sep 2019
  • Value of ST-segment change in lead aVR may help in diagnosing left main disease in non-ST-elevation acute coronary syndrome

  • A systematic review has confirmed the evidence that the ST-segment elevation (STE) in lead augmented vector right (aVR) is significant in the prediction of severe left main lesion or serious multivessel lesions. Previously, the aVR lead was commonly “ignored” and designated as the “neglected lead”.

    Researchers in Taiwan summarized the published data and evaluated the overall association of STE in lead aVR and left main coronary artery disease (LMD) in non-STE acute coronary syndrome.

    From the 27 published studies in their analysis, they found that compared with STE <0.05 mV, STE ≥0.05 mV was associated with a higher incidence rate of LMD (odds ratio [OR],  6.64; 95% confidence intervals [CI], 4.80–9.17), and the degree of STE in lead aVR was significantly associated with LMD. Also, myocardial infarction was more likely to occur in patients with STE ≥0.05 mV than in patients with STE <0.05 mV (OR, 3.12; 95% CI, 1.73–5.62).

    These findings show the STE in lead aVR and the degree of STE are independent predictors in diagnosing LMD or myocardial infarction.

    Reference:
    Lee GK, et al. Value of ST-segment change in lead aVR in diagnosing left main disease in Non-ST-elevation acute coronary syndrome-A meta-analysis Ann Noninvasive Electrocardiol 2019;e12692. doi: 10.1111/anec.12692. [Epub ahead of print]