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Liang H, Wu L, Li Y, et al. Electrocardiogram criteria of limb leads predicting right coronary artery as culprit artery in inferior wall myocardial infarction: A meta-analysis. Medicine (Baltimore). 2018;97(24):e10889doi: 10.1097/MD.0000000000010889.
Liang, H., Wu, L., Li, Y., Zeng, Y., Hu, Z., Li, X., Sun, X., Zhang, Q., & Zhou, X. (2018). Electrocardiogram criteria of limb leads predicting right coronary artery as culprit artery in inferior wall myocardial infarction: A meta-analysis. Medicine, 97(24), e10889. https://doi.org/10.1097/MD.0000000000010889
Liang, Hao, et al. "Electrocardiogram criteria of limb leads predicting right coronary artery as culprit artery in inferior wall myocardial infarction: A meta-analysis." Medicine vol. 97,24 (2018): e10889. doi: https://doi.org/10.1097/MD.0000000000010889
Liang H, Wu L, Li Y, Zeng Y, Hu Z, Li X, Sun X, Zhang Q, Zhou X. Electrocardiogram criteria of limb leads predicting right coronary artery as culprit artery in inferior wall myocardial infarction: A meta-analysis. Medicine (Baltimore). 2018 Jun;97(24):e10889. doi: 10.1097/MD.0000000000010889. PMID: 29901579; PMCID: PMC6024025.
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Medicine (Baltimore). 2018 Jun;97(24):e10889. doi: 10.1097/MD.0000000000010889.

Electrocardiogram criteria of limb leads predicting right coronary artery as culprit artery in inferior wall myocardial infarction: A meta-analysis.

Medicine

Hao Liang, Lan Wu, Yingchen Li, Yidi Zeng, Zhixi Hu, Xinchun Li, Xiang Sun, Qiuyan Zhang, Xiaoqing Zhou

Affiliations

  1. Institute of TCM Diagnostics Hunan Provincial Key Laboratory of TCM Diagnostics, Hunan University of Chinese Medicine The Third Xiangya Hospital, Central South University The Affiliated Hospital of Hunan Institute of Traditional Chinese Medicine, Hunan Institute of Traditional Chinese Medicine Cardiology Department, Hospital of Changsha, Changsha, Hunan, China.

PMID: 29901579 PMCID: PMC6024025 DOI: 10.1097/MD.0000000000010889

Abstract

BACKGROUND: Prior studies have proposed several electrocardiogram (ECG) criteria in limb leads for identifying the culprit coronary artery (CCA) in patients with acute inferior wall myocardial infarction (IWMI). The aim of our study was to conduct an evidence-based evaluation and test accuracy comparison of these criteria.

METHODS: We searched the PubMed, Embase, and Ovid. Eligible studies to assess the diagnostic performance of ECG criteria predicting CCA in IWMI were reviewed for inclusion. A diagnostic meta-analysis of bivariate approach was performed for pooled estimates of sensitivity and specificity, and meta-regression was implemented to investigate sources of heterogeneity.

RESULTS: Twenty-four studies with 4431 unique participants met the inclusion criteria. The pooled sensitivity and specificity for ST-segment elevation (STE) in III > II, ST-segment depression (STD) in I, STD in aVL, STD in aVL > I, STE in III > II, and STD in aVL > I were 0.91 (0.88-0.94) and 0.69 (0.53-0.81), 0.80 (0.73-0.87) and 0.69 (0.62-0.76), 0.90 (0.81-0.95) and 0.41 (0.22-0.62), 0.84 (0.75-0.91) and 0.72 (0.48-0.88), and 0.79 (0.62-0.90) and 1.00 (0.37-1.00), respectively. Heterogeneity investigation showed that whether multi-vessel diseased patients were excluded, sample size, publication year, etc., could influence the diagnostic performance.

CONCLUSION: STE in III > II performed better than other criteria for predicting RCA as CCA in IWMI, and STE in III > II and STD in aVL > I were potential and simple algorithms. ECG could be an effective tool to identify the CCA, but future studies are clearly needed to address the potential of diagnostic and prognostic value.

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