The Value Of Electrocardiogram In Predicting The Characteristics Of Coronary Angiography In Patients With Acute Myocardial Infarction

Objective: To investigate the value of Electrocardiogram changes in predicting coronary angiography outcomes in patients with acute myocardial infarction.Methods: A retrospective study was conducted in 120 patients with acute myocardial infarction who were randomly selected from September 2017 to April 2019 in our hospital and underwent emergency or selective CAG examination.The patients were divided into frontal QRS-T angle>90°group and frontal QRS-T angle ≤90°group according to QRS-T angle,ST segment elevation group and non ST segment elevation group according to ST segment changes in ECG related leads,QRS duration prolongation group and QRS duration normal group according to QRS complex time limit,lead number < 6group and lead number > 6 group according to ST segment change,T wave inversion group and non T wave inversion group according to T wave inversion,The correlation among the number of diseased vessels,the degree of stenosis of infarct related vessels and TIMI blood flow classification of infarct related vessels were analyzed.According to the results of univariate analysis,multivariate logistic regression analysis was used to find out the risk factors of complete occlusion of coronary artery in AMI patients.Results: There were 56 cases of frontal QRS-T angle>90°group,accounting for 46.7%,and 64 cases of frontal QRS-T angle≤90° group,accounting for 53.3%;58 cases of ST segment elevation group,accounting for 48.3%,and 62 cases of non ST elevation group,accounting for 51.7%;58 cases of ST segment elevation group,accounting for 48.3%,and 62 cases of non ST elevation group,accounting for 51.7%;72 cases of ST segment change lead number ≥6 group,accounting for 60%;48 cases of ST segment change lead number < 6 group,accounting for 40%;59 cases of QRS complex group≥100ms group,accounting for 49.2%;61 cases of QRS complex group< 100 ms group,accounting for 50.8%;33 cases of T wave inversion group,accounting for 27.5%,87 cases of non-T wave inversion group,accounting for 72.5%.The degree of stenosis in frontal QRS-T angle>90° group was more severe than that in frontal QRS-T angle≤90°group,the blood perfusion in QRS-T angle>90° group was weaker than that in frontal QRS-T angle≤90°group,the number of diseased branches in frontal QRS-T angle>90° group was more than that in QRS-T angle≤90°group,P<0.05;The degree of stenosis in ST elevation group was more severe than that in non ST segment elevation group,the blood perfusion in ST elevation group was weaker than that in non ST segment elevation group,the number of diseased branches in ST elevation group was more than that in non ST segment elevation group,P<0.05;the stenosis degree of group with more than 6 ST segment change leads was more than that of group with less than 6 ST segment change leads,and the blood perfusion of group with more than6 ST segment change leads was weaker than that of group with less than6 ST segment change leads The number of lesion branches in ≥6groups was more than that in ST segment change leads <6 groups,P<0.05;the degree of stenosis in QRS duration ≥100ms group was more than that in QRS duration <100ms group,it was considered that the blood flow perfusion in QRS time limit ≥100ms group was weaker than that in QRS time limit < 100 ms group,P < 0.05;T wave inversion was compared with coronary stenosis degree,blood flow perfusion and lesion branch number There was no significant difference(P >0.05).Multivariate logistic regression analysis showed that frontal QRS-T angle [OR=3.175,95% CI(1.232 ～8.183),P = 0.017],ST segment change [OR = 2.332,95% CI(1.265-4.299),P = 0.007],the number of leads of ST segment change [OR = 2.332,95% CI(1.265-4.299),P =0.007],QRS complex duration [OR = 2.332,95% CI(1.265-4.299),P =0.007] were the risk factors for complete occlusion in AMI patients.Conclusion: 1.The frontal QRS-T angle>90 °,the number of ST segment change leads and QRS complex duration ≥100ms in ECG related leads of AMI patients indicate the severity of coronary artery stenosis,low TIMI blood flow classification and multi vessel disease.2.STEMI has more coronary stenosis than NSTEMI,and more lesions in NSTEMI than in STEMI 3.There was no significant difference in the evaluation of coronary artery disease in AMI patients with T wave inversion.4.Frontal QRS-T angle>90°,ST segment elevation,ST segment altered lead number ≥6,QRS group duration ≥100ms are the risk factors for predicting complete vascular occlusion in AMI patients.