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J Korean Soc Emerg Med > Volume 27(1); 2016 > Article
Journal of The Korean Society of Emergency Medicine 2016;27(1): 43-51.
급성 관상동맥 증후군 환자에서 심전도 검사의 aVL 유도에서 보이는 T파 역전위 소견의 임상적 유용성
최영진1, 박상오1, 김종원1, 홍대영1, 이경룡1, 백광제1, 김근수2, 김상철3, 김진용3
1건국대학교 의학전문대학원 건국대병원 응급의학과
2김포우리병원 응급의학과
3건국대학교 의학전문대학원 충주병원 응급의학과
Clinical Usefulness of T wave Inversion in Lead aVL of ECG on Acute Coronary Syndrome Patients
Young Jin Choi1, Sang O Park1, Jong Won Kim1, Dae Young Hong1, Kyeong Ryong Lee1, Kwang Je Baek1, Keun Soo Kim2, Sang Chul Kim3, Jin Yong Kim3
1Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Hospital, Seoul, Korea
2Department of Emergency Medicine, Gimpo Woori Hospital, Gimpo, Korea
3Department of Emergency Medicine, School of Medicine, Konkuk University, Konkuk University Chungju Hospital, Chungju, Korea
Correspondence  Jin Yong Kim ,Tel: 043) 840-8332, Fax: 043) 840-8965, Email: palenova@kku.ac.kr,
Received: July 31, 2015; Revised: August 4, 2015   Accepted: October 22, 2015.  Published online: February 29, 2016.
The aim of the study is to evaluate the clinical usefulness of a TWI in the lead aVL of 12-lead ECG for predicting the left ascending artery (LAD) lesion, high risk, and 30-days mortality in patients with acute coronary syndrome (ACS).
A total of 275 patients who underwent coronary angiography under the diagnosis of ACS were analyzed retrospectively from Jan 2012 to December 2013.
A total of 355 patients underwent coronary angiography. Of these, 275 patients (77.5%) were diagnosed with ACS. Of these, 187 patients (68.0%) had a left LAD lesion. Of these, 111 patients (59.3%) had a mid-LAD lesion. Of these, only 23 patients (22.5%) showed a TWI in the aVL lead. However, regarding the prediction of the high risk group, if there is a TWI in the aVL, when compared with patients without a TWI in the aVL, the high risk rate is four times higher in the univariable logistic regression analysis and 2.687 times higher in the multivariable logistic regression analysis.
A TWI in the lead aVL of ECG of patients with chest pain in the ER was closely associated with high risk of ACS patients.
Key words: Electrocardiography, Acute coronary syndrome
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