Abstract 19842: The Association Between ST-Deviation in aVR in Anterior STEMI Patients Undergoing Primary PCI and Mortality

Introduction: In patients presenting with STEMI treated with fibrinolysis, the presence of ST-segment deviation in ECG lead aVR has been associated with increased short-term mortality. ECG lead aVR has been considered a marker for global myocardial ischemia. Primary PCI results in greater culprit vessel patency rate and is favored in high risk patients. Hypothesis: In patients with Anterior STEMI treated with primary PCI, after adjustment for other ECG and clinical features, the presence of ST-segment deviation in aVR will be associated with increased long-term mortality. Methods: From 2002-2012, we identified 1358 primary PCI cases were of Anterior STEMI without RBBB or LBBB. Of these, 1282 had ECG ST-deviation could be measured in all 12-leads. Patients were followed for up to 3 years. We used Cox proportional hazard models to assess relationship between the presence of ST-deviation in lead aVR to death. We adjusted for sum absolute ST-deviation in all other ECG leads, age, diabetes, and heart failure. ...