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Fragmented QRS and abnormal creatine kinase-MB are predictors of coronary artery disease in patients with angina and normal electrocardiographys
| Content Provider | Semantic Scholar |
|---|---|
| Author | Lee, Jung Joo Lee, Jae Hoon Jeong, Jin Woo Chung, Jun Young |
| Copyright Year | 2017 |
| 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. |
| Starting Page | 469 |
| Ending Page | 477 |
| Page Count | 9 |
| File Format | PDF HTM / HTML |
| PubMed reference number | 28415163v1 |
| Alternate Webpage(s) | https://doi.org/10.3904/kjim.2015.123 |
| DOI | 10.3904/kjim.2015.123 |
| Journal | The Korean journal of internal medicine |
| Volume Number | 32 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Angina Pectoris Arteriopathic disease Chest Pain Confidence Intervals Coronary Artery Disease Coronary angiography Creatine Kinase MB Isoenzyme Electrocardiography Obstructive Ureterocele Patients QRS axis:Angle:Point in time:Heart:Quantitative:EKG Structure of circumflex branch of left coronary artery angiogram |
| Content Type | Text |
| Resource Type | Article |
