Prognostic value of ST segment in aVR lead in non-ST segment elevation acute coronary syndrome

Abstract

Introduction: Recently it has been suggested that lead aVR on standard electrocardiogram may provide prognostic information in patients with non-ST segment elevation acute coronary syndrome. Objective: To evaluate the contribution of ST segment in lead aVR and the occurrence of cardiovascular death and in-hospital recurrence at 1-year follow-up. Methods: Observational, analytic prospective study in patients with Non-ST segment elevation acute coronary syndrome hospitalized in Coronary Care Unit at Hospital Enrique Cabrera from 02-05-2015 to 08-05-16. According to the ST segment in lead aVR, patients were divided into 3 groups. Multivariate analysis was performed. Results: 65 years and more (52.3%), white skin and male sex (69.5% and 61.4% respectively) with more than two comorbidities (56.8%) and Killip-Kimball class I (85.3%) were predominant. An increase in cardiovascular mortality and in-hospital recurrence at 1-year follow-up was observed in the ST segment elevation (lead aVR) group (18.9% and 35.2% [p=0.00]). Conclusion: ST segment elevation in lead aVR was a strong predictor of cardiovascular death and in-hospital recurrence in 1-year follow up (p=0.00 <0.05).