Risk Factors for Nonischemic St-segment Elevation in Patients With Electrocardiographic Left Ventricular Hypertrophy

Abstract

\n Background ST-segment elevation (STE) is not a specific change for ST-segment elevation myocardial infarction (STEMI). This may lead to a mistaken diagnosis of STEMI and false-positive cardiac catheterization laboratory activation. We aimed to investigate risk factors for STE secondary to electrocardiographic LVH in order to provide more information for differential diagnosis.Methods A total of 1,590 inpatients with electrocardiographic LVH without confounding factors (such as myocardial infarction) were enrolled in this study. Data on potential risk factors and patient characteristics were collected. Logistic regression analysis and receiver operating characteristic curve (ROC) were used to identify the risk of STE in patients with LVH.Results After reviewing the ECGs, 1590 cases of electrocardiographic LVH were divided into an ST-segment elevation group (STE group, 81 cases) and non-ST segment elevation group (1509 cases). Eighty-seven cases were randomly selected from the non-ST segment elevation group to form a new non-ST segment elevation group (non-STE group, 87 cases) for further analysis. The mean age of the 168 participants (119 men, 70.83%) was 62.33 ± 16.27. Multivariate analysis showed that stroke, infection, and the value of SV1+RV5 were significantly associated with STE secondary to LVH. The area under the receiver operating characteristic curve showed that the optimal value of SV1+RV5 cut-off for predicting STE was 4.805 (sensitivity: 40.74%; specificity: 80.46%; AUC: 0.634; 95% CI: 0.550–0.719; P < 0.05).Conclusions A value of SV1+RV5 larger than 4.8 mV, stroke, and infection are independent risk factors for STE in patients with electrocardiographic LVH.