aVR ST-segment changes and prognosis of ST-segment elevation myocardial infarction

Background Clinical importance of aVR lead-related changes in predicting the prognosis of acute myocardial infarction remains uncertain. The present study aimed to assess the value of ST-segment changes in aVR lead and the outcome and sequels of the first episode of acute ST-segment elevation myocardial infarction. Methods This prospective cohort study was conducted on patients suffering first episode of ST-segment elevation myocardial infarction and underwent percutaneous coronary intervention. Information was collected through hospital-recorded files reading. The electrocardiogram (ECG) was taken from the patients upon entering the hospital and followed-up for 30 days to assess cardiovascular complications. Results In patients with anterior STEMI, with the use of multivariate analysis, admission aVR ST elevation >= 1 mm was found to be a strong and independent predictor of major cardiovascular adverse events (MACE) within 30 days of discharging (P value for trend .002). In patients with inferior (+/- RV) ST-segment elevation myocardial infarction (STEMI), with the use of multivariate analysis, admission aVR ST depression >= 1 mm was found to be a strong and independent predictor of MACE within 30 days of discharging (P value for trend .01). Conclusion In patients with anterior STEMI, admission aVR STE >= 1 mm was found to be a strong and independent predictor of MACE within 30 days of discharging. On the other hand, in patients with inferior STEMI, aVR ST depression >= 1 mm was found to be a strong and independent predictor of MACE within 30 days of discharging.