Journal of Electrocardiology
Volume 42, Issue 2 , Pages 120-127, March 2009

Predicting the culprit artery in acute ST-elevation myocardial infarction and introducing a new algorithm to predict infarct-related artery in inferior ST-elevation myocardial infarction: correlation with coronary anatomy in the HAAMU Trial

  • Ilkka Tierala, MD

      Affiliations

    • Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
    • Corresponding Author InformationCorresponding author. Tel.: +358 3 31164141; fax: +358 3 31164157.
    • Authors Tierala and Nikus have contributed equally to the manuscript.
    • ,
  • Kjell C. Nikus, MD

      Affiliations

    • Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland
    • Authors Tierala and Nikus have contributed equally to the manuscript.
    • ,
  • Samuel Sclarovsky, MD

      Affiliations

    • Procardia Medical Center, Tel Aviv, Israel
    • ,
  • Mikko Syvänne, MD

      Affiliations

    • Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
    • ,
  • Markku Eskola, MD

      Affiliations

    • Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland
    • ,
  • the HAAMU Study Group

Received 2 November 2008 published online 23 January 2009.

Abstract 

Aims

The objective of this study is to predict the culprit artery from the electrocardiogram (ECG) by predefined criteria and to compare a new algorithm with a previous one for predicting the culprit artery in inferior ST-elevation myocardial infarction (STEMI).

Methods and Results

In “all-comers” (n = 187) with acute STEMI, with ECG and angiography from the acute phase, the positive and negative predictive values for the prediction of the left anterior descending coronary artery, left circumflex coronary artery, or right coronary artery as the infarct-related artery were 96% and 96%, 65% and 95%, 92% and 97%, respectively. In inferior STEMI (n = 98), positive and negative predictive values to predict the right coronary artery or the left circumflex coronary artery as the culprit artery were 92% and 75% and 75% and 94%, respectively.

Conclusions

In “all-comers” with STEMI, the culprit artery could be predicted by ECG criteria with high predictive values. In inferior STEMI, a new algorithm for culprit artery prediction was successfully tested.

Keywords: HAAMU Trial, Algorithm, ST-elevation myocardial infarction, ECG, Culprit artery

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PII: S0022-0736(08)00497-4

doi:10.1016/j.jelectrocard.2008.12.009

Journal of Electrocardiology
Volume 42, Issue 2 , Pages 120-127, March 2009

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