Please use this identifier to cite or link to this item: https://doi.org/10.1371/journal.pone.0160185
Title: Prevalence and associated clinical characteristics of exercise-induced ST-segment elevation in lead aVR
Authors: McKinney J.
Pitcher I.
Fordyce C.B.
Yousefi M.
Yeo T.J. 
Ignaszewski A.
Isserow S.
Chan S.
Ramanathan K.
Taylor C.M.
Keywords: adult
Article
cardiovascular parameters
controlled study
coronary angiography
coronary artery disease
Duke Treadmill Score
electrocardiogram
electrocardiograph electrode
exercise electrocardiography
female
heart catheterization
human
lead aVR
left anterior descending coronary artery
left coronary artery
major clinical study
male
metabolic equivalent
middle aged
prevalence
prognosis
retrospective study
ST segment elevation
thorax pain
treadmill exercise
aged
coronary artery disease
electrocardiography
exercise test
pathophysiology
procedures
Aged
Coronary Artery Disease
Electrocardiography
Exercise Test
Female
Humans
Male
Middle Aged
Issue Date: 2016
Citation: McKinney J., Pitcher I., Fordyce C.B., Yousefi M., Yeo T.J., Ignaszewski A., Isserow S., Chan S., Ramanathan K., Taylor C.M. (2016). Prevalence and associated clinical characteristics of exercise-induced ST-segment elevation in lead aVR. PLoS ONE 11 (7) : e0160185. ScholarBank@NUS Repository. https://doi.org/10.1371/journal.pone.0160185
Rights: Attribution 4.0 International
Abstract: Background: Exercise-induced ST-segment elevation (STE) in lead aVR may be an important indicator of prognostically important coronary artery disease (CAD). However, the prevalence and associated clinical features of exercise-induced STE in lead aVR among consecutive patients referred for exercise stress electrocardiography (ExECG) is unknown. Methods: All consecutive patients receiving a Bruce protocol ExECG for the diagnosis of CAD at a tertiary care academic center were included over a two-year period. Clinical characteristics, including results of coronary angiography, were compared between patients with and without exercise-induced STE in lead aVR. Results: Among 2227 patients undergoing ExECG, exercise-induced STE ?1.0mm in lead aVR occurred in 3.4% of patients. Patients with STE in lead aVR had significantly lower Duke Treadmill Scores (DTS) (-0.5 vs. 7.0, p<0.01) and a higher frequency of positive test results (60.2% vs. 7.3%, p<0.01). Furthermore, patients with STE in lead aVR were more likely to undergo subsequent cardiac catheterization than those without STE in lead aVR (p<0.01, odds ratio = 4.2). Conclusions: Among patients referred for ExECG for suspected CAD, exercise-induced STE in lead aVR was associated with a higher risk DTS, an increased likelihood of a positive ExECG, and referral for subsequent coronary angiography. These results suggest that exercise-induced STE in lead aVR may represent a useful ECG feature among patients undergoing ExECG in the risk stratification of patients. © 2016 McKinney et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Source Title: PLoS ONE
URI: https://scholarbank.nus.edu.sg/handle/10635/161564
ISSN: 19326203
DOI: 10.1371/journal.pone.0160185
Rights: Attribution 4.0 International
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This item is licensed under a Creative Commons License Creative Commons