ST ELEVATION IN AVR LEAD: RISK FACTORS AND CLINICAL IMPORTANCE

Introduction: Despite advances in the diagnosis and treatment of cardiovascular disease, coronary heart disease is still a major mortality problem worldwide. It is important to quickly and accurately identify and apply the appropriate treatment strategy to reduce the consequences of these diseases. ECG as a simple, non-invasive, and available pain tool plays a vital role in diagnosing, risk assessing, and determining the prognosis of this disease. The recently forgotten AVR lead has attracted much attention. Previous studies have assessed the independent predictive value of st-segment elevation in lead AVR for LM/3VD in acute coronary syndromes and have reported conflicting results. Methods: We performed a cross sectional study of 472 (mean age 61+/-14 years) patients with acute coronary syndromes that were admitted to our coronary care unit. All the ECGs in 472 patients were examined for ST-segment elevation in lead AVR. Echocardiography and laboratory finding was recorded and compared in this study, also coronary angiography that was performed within early 5 days were recorded and finally compared this data between two groups with and without AVR ST elevation. Results: Overall, 29% (137 patients) had more than 0.05mv STE in AVR lead. these patients had an increased prevalence of hypertension (p=0.016), in-hospital mortality (p=0.044), lower LVEF (p=0.010), more ST depression (p=0.000) in other leads and higher creatinine (p=0.004) and no relationship with angiographic finding (p=0.099). Conclusion: The results of this study showed that in patients with the acute coronary syndrome, the presence of ST Elevation in AVR lead is associated with in-hospital mortality and left ventricular ejection fraction decline and more attention should be paid to hospitalization, although the relationship between Angiographic results was not found, but the occurrence of such outcomes seems to be related to important coronary artery involvement such as LAD.