Study of coronary angiographic correlation with electrocardiography in patients of acute coronary syndrome-ST-elevation myocardial infarction

Background: Abnormalities in the 12-lead electrocardiography (ECG) are often used to localize the anatomic site of myocardial infarction (MI) and ischemia in patients with coronary artery disease. The same ECG findings are often assumed to correlate with anatomy of coronary arteries as well as the site of occlusion. Unfortunately, there is only limited documentation for correlation between the location of coronary artery occlusion and the finding of Q-waves during MI, thus tending to compromise the predictive value of ECG.Aims and Objectives: The objective of this study is to correlate the accuracy of ECG in localization of culprit coronary vessels involved in acute coronary syndrome-ST-elevation myocardial infarction (ACS-STEMI) and to combine various ECG criteria for localization of culprit vessel and the occlusion site to assess the diagnostic accuracy of ECG as compared to coronary angiographic findings.Materials and Methods: ECGs of patients with MI events, symptomatic or silent, were analyzed for STEMI or non-STEMI. One hundred patients with STEMI satisfying the inclusion and exclusion criteria were included as participants for the study. Coronary angiography was done after an event of acute MI or within 3 months after an event. ECG changes in various leads were used to localize the vessel involved and were correlated with dominant vessel involved in coronary angiography in development of MI. ECG criteria were used to localize the vessel involved. The statistical analysis was done using SPSS for windows version 16.0 software.Results and conclusions: We found that anterior wall myocardial infarction was more common than inferior wall myocardial infarction. Incidence of MI correlated positively with age. Acute MI was more common in males than females. Diabetes was more common risk factor for acute MI. ECG criteria utilized in our study were found to have high sensitivity and specificity, when combined together, in localizing culprit vessel in ACS-STEMI in left anterior descending artery, right coronary artery, and left circumflex coronary artery and this is in accordance with the studies conducted in other populations.