Study On The Three-level Early Warning Of "Red" "Yellow" And "Blue" In The Electrocardiogram Of The Left Main Coronary Artery Disease

Objective: This study is to find the best ECG pattern which can predict the left main coronary artery disease by comparing and analyzing the range and degree of ST segment deviation in the Standard 12 lead surface ECG.Methods: We collected the general clinical data and Standard 12 lead surface ECG of patients with onset of chest pain within 6 hours due to the unstable angina or non ST segment elevation myocardial infarction from January to October 2019 in the Department of Cardiology of Cangzhou central hospital.All patients underwent coronary angiography within 48 hours after admission.According to the results of coronary angiography,the patients were divided into positive group and negative group of left main coronary artery disease;The cases were divided into "4 +0","5+1" and "6+2" three groups according to the range of ST-segment elevation and depression.According to the degree of ST segment deviation,cases were also divided into "ΣST<12 mm","12≤ ΣST<18 mm" and "ΣST≥18 mm" three groups.We compared the general clinical data and the results of coronary angiography among these groups.Results: There was no statistically significant difference in general clinical data(gender,age,hypertension,diabetes mellitus,dyslipidemia,smoking history)among each group(P>0.05).The incidence of left main coronary artery disease in “4+0”,“5+1” and “6+2” groups were 7.2%,36.2% and 56.5%,respectively.The sensitivity of predicting left main coronary artery disease were 6.49%,32.47% and 50.65% respectively.The specificity were 45.60%,79.80% and 83.71% respectively.The accuracy were 37.76%,70.31% and 77.08% respectively.The incidence of left main coronary artery disease among the three groups of "Σ ST<12 mm","12≤ ΣST<1 mm" and "ΣST≥18mm" were 53.2%,36.4% and 10.4% respectively.The positive predictive value of left main coronary artery disease were 13.80%,48.28% and 27.59% respectively.The negative predictive value were 58.62%,84.97% and 80.56% respectively.The accuracy were 23.96%,79.43% and 76.56% respectively.Conclusion: The phenomenon of "6+2" in electrocardiogram is highly suggestive of left main coronary artery disease.The clinical practicability of "4+0" phenomenon is low.Combined with "ΣST ≥12 mm," if the phenomenon of "6 + 2","5 + 1" or "4 + 0" appears in the Standard 12 lead surface ECG,it can be used as the "red","yellow" and "blue" three-level early warning indicators to predict the left main coronary artery disease,respectively.