Association of Quantitative ST- Segment Depression with Early Mortality among Naive Patients of Non- ST- Segment Elevation Acute Coronary Syndrome

Abstract

Objective: To determine the association of quantitative ST– segment depression with early mortality within 30 day in patients with first non-ST – segment elevation acute coronary syndrome (NSTE-ACS).

Methodology: This descriptive case series study was conducted at the cardiology department of LUMHS, from October 2016 to March 2017. Patients with NSTE-ACS and positive cardiac biomarkers, patients older than 25 years and both genders admitted to CCU were included. The ST-Segment depression was assessed on 12 lead electrocardiography. The ST segment is the line that starts from the end of the QRS complex (J wave) to the beginning of the T wave. Normally ST segment is straight line and, isoelectric to base line, ST segment depressed below isoelectric line is said ST depression, down sloping or flat depressed ST segments indicate coronary ischemia, more than 0.5 mm ST depression significant for ischemia. All patients were followed for 30-days for early mortality. All information obtained was recorded on the study Performa.

Results: A total of 148 cases with acute myocardial infarction were integrated; the patient's average age was achieved as, 42.5±5.43 years, and males were in the majority 96(64%). On electrocardiography, ST-Segment depression was found in 60.13%, which is further divided into 0.5mm, >0.5-0.9 mm, >1-1.9 mm, and >2 mm with percentages of 12.83%, 22.29%, 16.89%, and 8.12%, respectively. Short term mortality was significantly associated with the severity of ST segment depression score (p-value 0.001).

Conclusions: In the study conclusion, the severity of ST-Segment depression score was observed to be significantly correlated with short term mortality (30-day) in cases with early NSTE-ACS.