Clinical value of electrocardiogram for the site of coronary artery vascular occlusion during acute myocardial infarction with ST segment elevation before the emergency PCI operation

Objective To assess the clinical value of electrocardiogram(ECG) for diagnosing the sites of coronary artery vascular occlusion during acute myocardial infarction(AMI)with ST segment elevation before emergency PCI operation.Methods The data of 18 leads ECG in 311 patients with ST segment elevation myocardial infarction were analyzed.The predicted sites of occluded vessel were compared with the results of coronary arteriography(CAG).Results The sensitivity and specificity of ECG were 88.1% and 81.2%(47/58),for acute extensive anterior wall myocardial infarction,90.2% and 79.6%(78/98),for anteroseptal myocardial infarction,69.3% and 57.7%(30/52),for anterolateral wall myocardial infarction.The sensitivity and specificity of ECG were 96.1% and 90.4%(47/52),for the proximal right coronary artery,83.3% and 92.7%(51/55),for the distal right coronary artery,50.0% and 97.0%(96/98),for circumflex branch of left coronary artery.Conclusion The results suggest that 18 leads ECG could forecast the related infarction coronary in most patients with acute myocardial infarction,which is conducive to the operation of emergency PCI,and has important clinical significance in guidance for the treatment of AMI with ST segment elevation,operational risk assessment and prognostic evaluation of patients.