engleski

Prognostic indicators of electrocardiographic changes and cardioselective enzymes in assessment of coronary artery disease severity

Background: Diagnostic procedure for acute coronary syndrome (ACS) involves electrocardiogram (ECG), providing the data on the presence, the extent and severity of myocardial ischemia. ECG changes in ACS with ST elevation (STE-ACS) indicate a clear pathophysiological mechanism and require urgent treatment. ACS without ST elevation (NSTE-ACS) and unstable angina pectoris (UAP) include ST segment depression, negative T wave, and even a normal ECG in patients with possible non- obstructive illness of major epicardial arteries or with changes at the level of coronary microcirculation. The research aimed to determine occurrence of ECG changes in patients with ACS without ST elevation and relations to the severity and localization of coronary artery disease (CAD) and risk factors. Patients and Methods: The research involved 33 adult patients (20 men and 13 women) that were hospitalized in the Department for heart and blood vessel diseases of the University Hospital Centre Osijek because of ACS without ST elevation. Excluded criteria were STE-ACS, heart failure, neurologic incident, septic condition, renal insufficiency, and anemia. All examinees were monitored for changeable and non-changeable conventional risk factors for CAD and ECG changes. They also underwent laboratory analyses, echocardiographic measurements and coronarography. Results: Average age of male examinees was 57.55±13.72, and of female examinees 67.69±10.36 years. ST segment depression was the most frequent in women (76%), while ST segment depression and negative T wave in men occurred equally (35%). Occurrence of single- vessel CAD was 45%, double-vessel CAD 18%, triple-vessel CAD 5%, left main coronary artery stenosis 6%, non- significant coronary diseases 21%, while 5% of examinees did not exhibit changes in major epicardial vessels. Correlation of triple- vessel CAD and maximum value of troponin was statistically significant, while there was no observed significant relation between ECG changes and the severity of CAD on the respective sample. Conclusion: For the purpose of early detection and appropriate treatment of high-risk patients with NSTE-ACS and UAP, it is necessary to take into account all risk factors according to gender difference, and to monitor early cardiac biomarkers and ECG changes.

acute coronary syndrome ; electrocardiogram ; coronarography

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