Validation of electrocardiographic criteria for predicting the culprit artery in patients with acute myocardial infarction

In this study we compare a variety of ECG criteria for predicting the culprit artery in cases with ST-segment elevation myocardial infarction (STEMI). We also assess the performance of these criteria for patients who did not meet the STEMI criteria although having an acute myocardial infarction (AMI). The study population consisted of 623 patients of whom 64.6% fulfilled STEMI criteria. All patients underwent percutaneous coronary intervention of a single vessel for treatment of AMI. The criteria proposed by Tierala have the highest performance for detecting the culprit artery in STEMI cases, although for some arteries specificity and sensitivity values were low. Performances are significantly lower in patients who do not meet the STEMI criteria. Improved criteria that better predict the culprit artery in the whole group of AMI patients are currently under investigation.