Abstract:

Objective: ST-elevation and depression in augmented voltage right (aVR) are associated with high mortality and prolonged coronary artery disease in patients with the acute coronary syndrome. It was aimed to compare the patients in terms of cardiac troponin, three-vessel disease, serum osmolarity and mortality. Methods: The study was performed through retrospective scanning of the files of 372 (162 females, mean age 64±10 years) patients who were admitted to the emergency department due to chest pain between January 2014 and December 2016 and who were admitted to the cardiology clinic with the diagnosis of the acute coronary syndrome. Patients with ST-elevation in aVR were included in Group I and patients with ST-depression in aVR were included in Group II. Results: Osmolarity was 295.8±16 in Group I and 291.7±8.1 in Group II. Troponin values in Group I was higher than Group II (p=0.002). The Gensini score was 40±2.7 in Group I and 28.6±2.3 in Group II (p=0.001). In Group I, unstable angina was found in 32 (18.1%) patient, ST-elevated myocardial infarction (MI) in 135 (76.3%) and non-ST-elevated MI in 10 (5.6%), whereas these numbers and percentages were 62 (31.8%), 106 (54.4%) and 27 (13.8%) in Group II, respectively (p=0.001). The three-vessel disease was found in 56 (31.6%) patients in Group I and 29 (14.9%) patients in Group II (p=0.001). The most common complication in both groups was ischemic heart failure. Mortality was observed in 36 (20.3%) patients in Group I and 14 (7.2%) in Group II. Osmolarity was lowest in unstable angina, highest in non-ST-elevation MI, and was also higher in three-vessel disease, men, and patients with mortality. Conclusion: In patients with acute coronary syndrome, osmolarity may predict ST-elevation and depression in aVR, three-vessel disease, and mortality.

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