Fragmented QRS and abnormal creatine kinase-MB are predictors of coronary artery disease in patients with angina and normal electrocardiographys
The Korean Journal of Internal Medicine
; : 469-477, 2017.
Article
en En
| WPRIM
| ID: wpr-138433
Biblioteca responsable:
WPRO
ABSTRACT
BACKGROUND/AIMS: Patients with symptoms of coronary artery disease (CAD) often display normal tracings or only nonspecific changes on electrocardiography (ECG). The aim of this study was to explore strategic elements of the ECG and other potential factors that are predictive of CAD in this scenario. METHODS: This was an observational study of 142 patients with the chief complaint of chest pain, each of whom presented with a normal ECG and was subjected to emergency coronary angiography (CAG). Two population subsets were identified: those patients (n = 97) with no significant stenotic lesions and those (n = 45) with the significant stenotic lesions of CAD. RESULTS: Those patients with normal or nonspecific ECGs and CAD (15.8%) were more likely to have left circumflex artery involvement (20% vs. 7%). In patients with normal ECGs and CAD (vs. normal CAG), male sex (86.7% vs. 68%, p = 0.023), creatine kinase-MB (CK-MB) levels > 10 U/L (13 vs. 10, p = 0.025), and fragmented QRS (fQRS) (38.6% vs. 21.6%, p = 0.042) occurred with greater frequency. In multivariable analysis, the following variables were significant predictors of CAD, given a normal ECG: male sex (odds ratio [OR], 2.593; 95% confidence interval [CI], 1.068 to 5.839); CK-MB (OR, 2.497; 95% CI, 0.955 to 7.039); and W- or M-shaped QRS complex (OR, 2.306; 95% CI 0.988 to 5.382). CONCLUSIONS: In our view, male sex, elevated CK-MB (> 10 U/L), and fQRS complexes are suspects for CAD in patients with angina and unremarkable ECGs and should be considered screening tests.
Palabras clave
Texto completo:
1
Base de datos:
WPRIM
Asunto principal:
Arterias
/
Dolor en el Pecho
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Enfermedad de la Arteria Coronaria
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Angiografía
/
Tamizaje Masivo
/
Angiografía Coronaria
/
Enfermedad Coronaria
/
Vasos Coronarios
/
Creatina
/
Electrocardiografía
Tipo de estudio:
Observational_studies
/
Prognostic_studies
/
Screening_studies
Límite:
Humans
/
Male
Idioma:
En
Revista:
The Korean Journal of Internal Medicine
Año:
2017
Tipo del documento:
Article