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7119585 
Journal Article 
ST-Segment Elevation of Right Precordial Lead (V4R) Is Associated with Multivessel Disease and Increased In-Hospital Mortality in Acute Anterior Myocardial Infarction Patients 
Tusun, E; Sahin, O; Eren, M; Bolca, O; Uluganyan, M; Ugur, M; Karaca, G; Osman, F; Koroglu, B; Murat, A; Ekmekci, A; Uyarel, H; , 
2015 
Yes 
Annals of Noninvasive Electrocardiology
ISSN: 1082-720X
EISSN: 1542-474X 
WILEY 
HOBOKEN 
362-367 
25209301 
WOS:000357889900007 
BackgroundST segment elevation of chest lead V4R is associated with worse prognosis in acute inferior ST-elevation myocardial infarction (STEMI). This study tried to determine the relationship between ST elevation in the right precordial lead V4R and acute anterior STEMI.MethodsProspective study of 144 consecutive anterior STEMI patients: all had 15-lead ECG recordings (12 conventional leads and V3R-V5R) obtained. Patients were classified into two groups on the basis of presence (Group I, 50 patients) or absence (Group II, 94 patients) of ST-segment elevation 0.5 mm in lead V4R.ResultsMultivessel involvement was significantly higher in Group I compared with Group II (54% and 23% respectively, P < 0.001). Major adverse cardiac events and in-hospital mortality was also significantly higher for those in Group I (P < 0.02 for both). A significant correlation was found between in-hospital mortality and those in Group I (P = 0.03, OR: 6.27, CI: 1.22-32.3). There was an independent relationship between in-hospital mortality and V4R-ST elevation (P = 0.03, OR: 11.64, CI: 1.3-27.4).ConclusionST segment elevation in chest lead V4R is associated with multivessel disease and increased in-hospital mortality in patients with anterior STEMI that had undergone primary percutaneous coronary intervention to the left anterior descending artery.