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ACC-AHA Ischemic ECG Changes

MedGen UID:
859763
•Concept ID:
C3900169
•
Finding

Definition

An electrocardiographic finding, in the absence of left ventricular hypertrophy (LVH) and left bundle branch block pattern on ECG, of either a) new (or presumed new) ST elevation at the J point in two contiguous leads with the following cut-points: greater than or equal to 0.1 mV in all leads other than leads V2-V3 where the following cut points apply: greater than or equal to 0.2 mV in men age greater than or equal to 40 years, greater than or equal to 0.25 mV in men age greater than 40 years, or greater than or equal to 0.15 mV in women; or b) new (or presumed new) horizontal or down-sloping ST depression greater than or equal to 0.05 mV in two contiguous leads, and/or T wave inversion greater than or equal to 0.1 mV in two contiguous leads with a prominent R wave, or R/S ratio greater than 1. (Thygesen K, Alpert JS, Jaffe AS, et al.: the Writing Group on behalf of the Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction. J Am Coll Cardiol 60(16):1-18, 2012) [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVACC-AHA Ischemic ECG Changes

Recent clinical studies

Etiology

World Health Organization definition of myocardial infarction: 2008-09 revision.
Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, Lisheng L; Writing group on behalf of the participating experts of the WHO consultation for revision of WHO definition of myocardial infarction
Int J Epidemiol 2011 Feb;40(1):139-46. Epub 2010 Oct 5 doi: 10.1093/ije/dyq165. PMID: 20926369
Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation.
Alcock RF, Roy P, Adorini K, Lau GT, Kritharides L, Lowe HC, Brieger DB, Freedman SB
Int J Cardiol 2010 Apr 1;140(1):66-72. Epub 2009 Jan 7 doi: 10.1016/j.ijcard.2008.11.005. PMID: 19131135
Temporal changes in the use of drug-eluting stents for patients with non-ST-Segment-elevation myocardial infarction undergoing percutaneous coronary intervention from 2006 to 2008: results from the can rapid risk stratification of unstable angina patients supress ADverse outcomes with early implementation of the ACC/AHA guidelines (CRUSADE) and acute coronary treatment and intervention outcomes network-get with the guidelines (ACTION-GWTG) registries.
Roe MT, Chen AY, Cannon CP, Rao S, Rumsfeld J, Magid DJ, Brindis R, Klein LW, Gibler WB, Ohman EM, Peterson ED; CRUSADE and ACTION-GWTG Registry Participants
Circ Cardiovasc Qual Outcomes 2009 Sep;2(5):414-20. Epub 2009 Jul 28 doi: 10.1161/CIRCOUTCOMES.109.850248. PMID: 20031871
Early treatment for non-ST-segment elevation acute coronary syndrome is associated with appropriate discharge care.
Fermann GJ, Raja AS, Peterson ED, Roe MT, Hoekstra JW, Milford-Beland S, Diercks DB, Pollack CV Jr, Peacock WF, Summers R, Ohman EM, Gibler WB
Clin Cardiol 2009 Sep;32(9):519-25. doi: 10.1002/clc.20629. PMID: 19743495Free PMC Article
The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.
Armstrong PW, Bogaty P, Buller CE, Dorian P, O'Neill BJ; Canadian Cardiovascular Society Working Group
Can J Cardiol 2004 Sep;20(11):1075-9. PMID: 15457302

Diagnosis

World Health Organization definition of myocardial infarction: 2008-09 revision.
Mendis S, Thygesen K, Kuulasmaa K, Giampaoli S, Mähönen M, Ngu Blackett K, Lisheng L; Writing group on behalf of the participating experts of the WHO consultation for revision of WHO definition of myocardial infarction
Int J Epidemiol 2011 Feb;40(1):139-46. Epub 2010 Oct 5 doi: 10.1093/ije/dyq165. PMID: 20926369
Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation.
Alcock RF, Roy P, Adorini K, Lau GT, Kritharides L, Lowe HC, Brieger DB, Freedman SB
Int J Cardiol 2010 Apr 1;140(1):66-72. Epub 2009 Jan 7 doi: 10.1016/j.ijcard.2008.11.005. PMID: 19131135
Temporal changes in the use of drug-eluting stents for patients with non-ST-Segment-elevation myocardial infarction undergoing percutaneous coronary intervention from 2006 to 2008: results from the can rapid risk stratification of unstable angina patients supress ADverse outcomes with early implementation of the ACC/AHA guidelines (CRUSADE) and acute coronary treatment and intervention outcomes network-get with the guidelines (ACTION-GWTG) registries.
Roe MT, Chen AY, Cannon CP, Rao S, Rumsfeld J, Magid DJ, Brindis R, Klein LW, Gibler WB, Ohman EM, Peterson ED; CRUSADE and ACTION-GWTG Registry Participants
Circ Cardiovasc Qual Outcomes 2009 Sep;2(5):414-20. Epub 2009 Jul 28 doi: 10.1161/CIRCOUTCOMES.109.850248. PMID: 20031871
Patterns of transfer for patients with non-ST-segment elevation acute coronary syndrome from community to tertiary care hospitals.
Roe MT, Chen AY, Delong ER, Boden WE, Calvin JE Jr, Cairns CB, Smith SC Jr, Pollack CV Jr, Brindis RG, Califf RM, Gibler WB, Ohman EM, Peterson ED
Am Heart J 2008 Jul;156(1):185-92. Epub 2008 Apr 14 doi: 10.1016/j.ahj.2008.01.033. PMID: 18585515
The 2004 ACC/AHA Guidelines: a perspective and adaptation for Canada by the Canadian Cardiovascular Society Working Group.
Armstrong PW, Bogaty P, Buller CE, Dorian P, O'Neill BJ; Canadian Cardiovascular Society Working Group
Can J Cardiol 2004 Sep;20(11):1075-9. PMID: 15457302

Therapy

2009 update of the ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction and guidelines on percutaneous coronary intervention: what should we change in clinical practice?
King SB 3rd
Pol Arch Med Wewn 2010;120(1-2):6-8. PMID: 20150837
Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation.
Alcock RF, Roy P, Adorini K, Lau GT, Kritharides L, Lowe HC, Brieger DB, Freedman SB
Int J Cardiol 2010 Apr 1;140(1):66-72. Epub 2009 Jan 7 doi: 10.1016/j.ijcard.2008.11.005. PMID: 19131135
Early treatment for non-ST-segment elevation acute coronary syndrome is associated with appropriate discharge care.
Fermann GJ, Raja AS, Peterson ED, Roe MT, Hoekstra JW, Milford-Beland S, Diercks DB, Pollack CV Jr, Peacock WF, Summers R, Ohman EM, Gibler WB
Clin Cardiol 2009 Sep;32(9):519-25. doi: 10.1002/clc.20629. PMID: 19743495Free PMC Article
Improving Door-to-Drug time and ST segment resolution in AMI by moving thrombolysis administration to the Emergency Department.
McLean S, O'Reilly M, Doyle M, O Rathaille M
Accid Emerg Nurs 2004 Jan;12(1):2-9. doi: 10.1016/s0965-2302(03)00062-6. PMID: 14700564
Intracoronary stenting for acute and threatened closure complicating percutaneous transluminal coronary angioplasty.
Roubin GS, Cannon AD, Agrawal SK, Macander PJ, Dean LS, Baxley WA, Breland J
Circulation 1992 Mar;85(3):916-27. doi: 10.1161/01.cir.85.3.916. PMID: 1537128

Prognosis

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation.
Alcock RF, Roy P, Adorini K, Lau GT, Kritharides L, Lowe HC, Brieger DB, Freedman SB
Int J Cardiol 2010 Apr 1;140(1):66-72. Epub 2009 Jan 7 doi: 10.1016/j.ijcard.2008.11.005. PMID: 19131135
Patterns of transfer for patients with non-ST-segment elevation acute coronary syndrome from community to tertiary care hospitals.
Roe MT, Chen AY, Delong ER, Boden WE, Calvin JE Jr, Cairns CB, Smith SC Jr, Pollack CV Jr, Brindis RG, Califf RM, Gibler WB, Ohman EM, Peterson ED
Am Heart J 2008 Jul;156(1):185-92. Epub 2008 Apr 14 doi: 10.1016/j.ahj.2008.01.033. PMID: 18585515
Improving Door-to-Drug time and ST segment resolution in AMI by moving thrombolysis administration to the Emergency Department.
McLean S, O'Reilly M, Doyle M, O Rathaille M
Accid Emerg Nurs 2004 Jan;12(1):2-9. doi: 10.1016/s0965-2302(03)00062-6. PMID: 14700564
Intracoronary stenting for acute and threatened closure complicating percutaneous transluminal coronary angioplasty.
Roubin GS, Cannon AD, Agrawal SK, Macander PJ, Dean LS, Baxley WA, Breland J
Circulation 1992 Mar;85(3):916-27. doi: 10.1161/01.cir.85.3.916. PMID: 1537128

Clinical prediction guides

Incidence and determinants of myocardial infarction following percutaneous coronary interventions according to the revised Joint Task Force definition of troponin T elevation.
Alcock RF, Roy P, Adorini K, Lau GT, Kritharides L, Lowe HC, Brieger DB, Freedman SB
Int J Cardiol 2010 Apr 1;140(1):66-72. Epub 2009 Jan 7 doi: 10.1016/j.ijcard.2008.11.005. PMID: 19131135
Patterns of transfer for patients with non-ST-segment elevation acute coronary syndrome from community to tertiary care hospitals.
Roe MT, Chen AY, Delong ER, Boden WE, Calvin JE Jr, Cairns CB, Smith SC Jr, Pollack CV Jr, Brindis RG, Califf RM, Gibler WB, Ohman EM, Peterson ED
Am Heart J 2008 Jul;156(1):185-92. Epub 2008 Apr 14 doi: 10.1016/j.ahj.2008.01.033. PMID: 18585515

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