Enhanced Diagnostic Accuracy of Electrocardiogram Using Additional ECG Markers for Detecting Acute Coronary Occlusion in Myocardial Infarction

Abstract

Abstract

Objective

The aim of this study was to evaluate the diagnostic accuracy of using additional electrocardiographic markers alongside traditional ST-segment elevation (STE) in the detection of acute coronary occlusion (ACO) in patients presenting with myocardial infarction taking angiographic evidence of coronary artery occlusion as the gold standard.

Study design and Setting

This cross-sectional study was conducted at Army Cardiac Hospital.

Methodology

After the permission from institute review board this study was conducted from 11 August, 2025 to 11 November, 2025 under the principles of Helsinki Declaration. Consecutive sampling technique was used to enroll patients in this study.

Results

In this study the mean age of the cases was 60.80 ± 8.40. There were 105 (70%) male and 45 (30%) females found in this study. The comparison of ECG type, ECG ACO, angiographic ACO and composite ACO showed significant results with p-values < 0.001, <0.001, 0.002 and < 0.001. The sensitivity and specificity of angiographic results was computed as 73.56% and 93.65%, PPV and NPV was 94.12% and 71.95%.

Conclusion

Electrocardiogram can be used to detect the culprit coronary in the settings of automated prehospital 12 lead ECG machine so that the paramedics can identify the coronaries involved and appropriately refer the patient to PCI capable centers and reduce the time required for the triage of patients with STEMI and the duration of their appropriate treatment hence it will help the physician reduced the door to needle time.

Key Words: Acute coronary occlusion, Electrocardiogram, ST-segment elevation