Ephic algorithm for assignment of occluded vessel in acute myocardial infarction

a ¨ ¨¨ Abstract Background: This study was performed to elaborate an electrocardiographic (ECG) algorithm enabling assignment of an occluded coronary artery in acute myocardial infarction (AMI). Patients and Interventions: In 109 patients (age, 59612 years) with AMI (pain onset, 3.661.7 h), coronary angiography with PTCA / stenting of the culprit lesion was performed. The diagnosis of AMI was confirmed by emergency coronary angiography and laboratory analyses. Admission ECG parameters (amplitude of R-wave, ST-segment deviation, presence of Q-wave, deflection of T-wave) in standard 12-lead ECG plus extended (V R to V R and V ) leads were subjected to 36 7 - 9 classification and regression tree (CART) analysis. Results: Continuous CART analysis assessed ST-segment deviations in V and V R. 25 AMI of the left anterior descending (LAD), right coronary artery (RCA) and left circumflex coronary artery (CX) were correctly classified in 94, 64, and 91% of cases, respectively. Dichotomised CART analysis assessed ST-segment deviations in V , V R, and aVF. True