PMID- 16226097
OWN - NLM
STAT- MEDLINE
DCOM- 20060413
LR  - 20180223
IS  - 0022-0736 (Print)
IS  - 0022-0736 (Linking)
VI  - 38
IP  - 4 Suppl
DP  - 2005 Oct
TI  - Designing prehospital ECG systems for acute coronary syndromes. Lessons learned 
      from clinical trials involving 12-lead ST-segment monitoring.
PG  - 180-5
AB  - BACKGROUND: Clinical trials in prehospital electrocardiography have focused 
      primarily on ST elevation myocardial infarction (STEMI). The aims of this study 
      were to determine, in patients presenting to the emergency department with acute 
      coronary syndrome (ACS), the (1) relative frequency of various ACS types and (2) 
      sensitivity of conventional ST-T criteria for diagnosing ischemia in non-STEMI or 
      unstable angina. METHODS: A secondary analysis was conducted using data from 
      prospective trials involving 12-lead ST monitoring. RESULTS: Of 968 patients with 
      ACS, 120 (12%) were STEMI, 289 (30%) were non-STEMI, and 559 (58%) were unstable 
      angina. Conventional electrocardiogram (ECG) criteria were insensitive 
      (sensitivity, 20%) for detecting ischemia in patients with non-STEMI or unstable 
      angina. There was no ischemia on the initial ECG in 85 patients who had 
      subsequent events with ST monitoring. CONCLUSION: Non-STEMI and unstable angina 
      are the most prevalent types of ACS. The initial ECG is insensitive for detecting 
      ischemia in this population. Transient myocardial ischemia detected with ST 
      monitoring commonly occurs in patients without ischemia on the initial ECG. ST 
      monitoring should be considered in designing prehospital ECG systems.
FAU - Drew, Barbara J
AU  - Drew BJ
AD  - Department of Physiological Nursing, University of California, San Francisco, CA 
      94143, USA. barbara.drew@nursing.ucsf.edu
FAU - Pelter, Michele M
AU  - Pelter MM
FAU - Lee, Eunyoung
AU  - Lee E
FAU - Zegre, Jessica
AU  - Zegre J
FAU - Schindler, Daniel
AU  - Schindler D
FAU - Fleischmann, Kirsten E
AU  - Fleischmann KE
LA  - eng
GR  - R01 HL069753/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
SB  - IM
MH  - Acute Disease
MH  - Clinical Trials as Topic
MH  - Coronary Disease/*diagnosis/physiopathology
MH  - *Electrocardiography
MH  - Emergency Medical Services/*methods
MH  - Humans
MH  - Myocardial Ischemia/diagnosis
MH  - Prospective Studies
MH  - San Francisco
MH  - Sensitivity and Specificity
MH  - Syndrome
EDAT- 2005/10/18 09:00
MHDA- 2006/04/14 09:00
CRDT- 2005/10/18 09:00
PHST- 2005/06/10 00:00 [received]
PHST- 2005/06/10 00:00 [accepted]
PHST- 2005/10/18 09:00 [pubmed]
PHST- 2006/04/14 09:00 [medline]
PHST- 2005/10/18 09:00 [entrez]
AID - S0022-0736(05)00143-3 [pii]
AID - 10.1016/j.jelectrocard.2005.06.031 [doi]
PST - ppublish
SO  - J Electrocardiol. 2005 Oct;38(4 Suppl):180-5. doi: 
      10.1016/j.jelectrocard.2005.06.031.