| ObjectiveTo investigate the correlation and predictive value of the T-wave direction in lead aVR and the degree of coronary artery disease in patients with acute ST-segment elevation myocardial infarction(ASTEMI).MethodA total of 164 ASTEMI patients with complete,definite diagnosis and undergoing primary PCI operation who were admitted to the department of cardiology of the First Hospital of Quanzhou Affiliated to Fujian Medical University from January 2016 to December 2016.According to the direction of the T-wave in lead aVR of the electrocardiogram at the time of admission,the patients were divided into T-wave positive(T?0mv)or T-wave negative(T<0mv).The coronary artery disease,infarct-related coronary artery,the number of coronary lesions,SYNTAX score,and clinical prognosis were compared between the two groups.The data were analyzed by SPSS 22.0 statistical software,and bilateral tests were used,and P<0.05 believed that the difference was statistically significant.Result 1.1 Comparison of demographic information between the two groups,the results showed that T-wave positive group were older than T-wave negative group(P<0.05);there was no significant difference in sex(P>0.05).1.2 The study showed that there was no significant difference in smoking,hypertension,diabetes,TG,TC,Scr,CK-MB,TNI and aVR ST elevation differences between the two groups in the general clinical data(P>0.05).2.1 There was significant difference about the two groups in LM,LAD,LCX and RCA about coronary artery lesions(P<0.05).2.2 The infarct related vascular on the T-wave positive group was higher than that T-wave negative group(P<0.05);there was no significant difference in LAD,LCX,RCA in it(P>0.05).2.3 The multiple coronary artery disease on the T-wave positive group was higher than that T-wave negative group(P<0.05);The single coronary artery disease on the T-wave negative group was higher than that T-wave positive group(P<0.05);there was no significant difference in the coronary double branch lesion(P>0.05).2.4 The Spearman correlation analysis showed that there has a positive and significant correlation between the multiple coronary artery disease and the T-wave positive group(P<0.05).3.1 The Spearman correlation analysis showed that there has a positive and significant correlation between the T-wave positive group and the SYNTAX score(P<0.05).3.2 There were significant differences between the two groups in the low-risk,the intermediate-risk group and the high-risk group about the SYNTAX score(P<0.05).3.3 There were significant differences on the T-wave positive group in the low-risk,the intermediate-risk group and the high-risk group about the SYNTAX score(P<0.05).4 The T-wave positive group had a longer hospital stay than those in the T-wave negative group.The T-wave positive group had a higher proportion of major adverse cardiovascular and cerebrovascular events than those in the T-wave negative group.The T-wave positive group had more lower fraction of the left ventricular ejection than those in the T-wave negative group(P<0.05).5 Using multivariate logistic regression analysis,it showed that the T-wave positive group alone remained an indenpent and risk factors of the major adverse cardiovascular events during hospitalization(OR=3.701,95% CI: 1.346-10.175,P=0.011<0.05).ConclusionThere is a correlation between the direction of T-wave in lead aVR and the extent of coronary artery disease in patients with acute ST-segment elevation myocardial infarction(ASTEMI);the SYNTAX score is related to the formation of the T-wave positive in the aVR lead.The T-wave positive group can predict the risk of cardiovascular and cerebrovascular events during hospitalization and has important predictive significance for its poor prognosis. |
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