Journal article
ECG analysis in patients with acute coronary syndrome undergoing invasive management: rationale and design of the electrocardiography sub-study of the MATRIX trial.
- Gragnano F Swiss Cardiovascular Center, Inselspital Bern, University of Bern, Bern, Switzerland.
- Spedicato V Swiss Cardiovascular Center, Inselspital Bern, University of Bern, Bern, Switzerland.
- Frigoli E Clinical Trials Unit, University of Bern, Bern, Switzerland.
- Gargiulo G Swiss Cardiovascular Center, Inselspital Bern, University of Bern, Bern, Switzerland; Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Di Maio D Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Fimiani F Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Fioretti V Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Annoiato C Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Cimmino M Azienda Ospedaliera Policlinico "Gaetano Martino", University of Messina, Messina, Italy.
- Esposito F Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Chianese S Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Scalise M Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Fimiani L Azienda Ospedaliera Policlinico "Gaetano Martino", University of Messina, Messina, Italy.
- Franzese M Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Monda E Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Schiavo A Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Cesaro A Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- De Michele A Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Scalise R Azienda Ospedaliera Policlinico "Gaetano Martino", University of Messina, Messina, Italy.
- Caracciolo A Azienda Ospedaliera Policlinico "Gaetano Martino", University of Messina, Messina, Italy.
- Andò G Azienda Ospedaliera Policlinico "Gaetano Martino", University of Messina, Messina, Italy.
- Stabile E Division of Cardiology, Department of Advanced Biomedical Sciences, University of Naples Federico II, Naples, Italy.
- Windecker S Swiss Cardiovascular Center, Inselspital Bern, University of Bern, Bern, Switzerland.
- Calabrò P Division of Cardiology, A.O.R.N. "Sant'Anna e San Sebastiano", Caserta, Italy; Division of Cardiology, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
- Valgimigli M Swiss Cardiovascular Center, Inselspital Bern, University of Bern, Bern, Switzerland. Electronic address: marco.valgimigli@insel.ch.
- 2019-09-07
Published in:
- Journal of electrocardiology. - 2019
Acute coronary syndromes
Atrial infarction
ECG
Myocardial infarction
Percutaneous coronary intervention
Radial access
English
BACKGROUND
The twelve‑lead electrocardiogram (ECG) has become an essential tool for the diagnosis, risk stratification, and management of patients with acute coronary syndromes (ACS). However, several areas of residual controversies or gaps in evidence exist. Among them, P-wave abnormalities identifying atrial ischemia/infarction are largely neglected in clinical practice, and their diagnostic and prognostic implications remain elusive; the value of ECG to identify the culprit lesion has been investigated, but validated criteria indicating the presence of coronary occlusion in patients without ST-elevation are lacking; finally, which criteria among the multiple proposed, better define pathological Q-waves or success of revascularisation deserve further investigations.
METHODS
The Minimizing Adverse hemorrhagic events via TRansradial access site and systemic Implementation of AngioX (MATRIX) trial was designed to test the impact of bleeding avoidance strategies on ischemic and bleeding outcomes across the whole spectrum of patients with ACS receiving invasive management. The ECG-MATRIX is a pre-specified sub-study of the MATRIX programme which aims at analyzing the clinical value of ECG metrics in 4516 ACS patients (with and without ST-segment elevation in 2212 and 2304 cases, respectively) with matched pre and post-treatment ECGs.
CONCLUSIONS
This study represents a unique opportunity to further investigate the role of ECGs in the diagnosis and risk stratification of ACS patients with or without ST-segment deviation, as well as to assess whether the radial approach and bivalirudin may affect post-treatment ECG metrics and patterns in a large contemporary ACS population.
The twelve‑lead electrocardiogram (ECG) has become an essential tool for the diagnosis, risk stratification, and management of patients with acute coronary syndromes (ACS). However, several areas of residual controversies or gaps in evidence exist. Among them, P-wave abnormalities identifying atrial ischemia/infarction are largely neglected in clinical practice, and their diagnostic and prognostic implications remain elusive; the value of ECG to identify the culprit lesion has been investigated, but validated criteria indicating the presence of coronary occlusion in patients without ST-elevation are lacking; finally, which criteria among the multiple proposed, better define pathological Q-waves or success of revascularisation deserve further investigations.
METHODS
The Minimizing Adverse hemorrhagic events via TRansradial access site and systemic Implementation of AngioX (MATRIX) trial was designed to test the impact of bleeding avoidance strategies on ischemic and bleeding outcomes across the whole spectrum of patients with ACS receiving invasive management. The ECG-MATRIX is a pre-specified sub-study of the MATRIX programme which aims at analyzing the clinical value of ECG metrics in 4516 ACS patients (with and without ST-segment elevation in 2212 and 2304 cases, respectively) with matched pre and post-treatment ECGs.
CONCLUSIONS
This study represents a unique opportunity to further investigate the role of ECGs in the diagnosis and risk stratification of ACS patients with or without ST-segment deviation, as well as to assess whether the radial approach and bivalirudin may affect post-treatment ECG metrics and patterns in a large contemporary ACS population.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jelectrocard.2019.08.045
- PMID 31491602
- Persistent URL
- https://sonar.ch/global/documents/44319
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