Computerized classification of proximal occlusion in the left anterior descending coronary artery.

Proximal occlusion within the left anterior descending (LAD) coronary artery in patients with acute myocardial infarction leads to higher mortality than does nonproximal occlusion. We evaluated an automated program to detect proximal LAD occlusion. All patients with suspected acute coronary syndrome...

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Publicado en:Journal of Electrocardiology Vol. 43; no. 6; pp. 634 - 640
Autores principales: Gregg RE, Nikus KC, Zhou SH, Startt Selvester RH, Barbara V, Gregg, Richard E, Nikus, Kjell C, Zhou, Sophia H, Startt Selvester, Ronald H, Barbara, Victoria
Formato: research Journal Article
Publicado: W B Saunders Nov2010
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Nov2010
      vid: 43
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      pub: W B Saunders
      place: Philadelphia, Pennsylvania
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        104943530
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        2010856819
        10.1016/j.jelectrocard.2010.07.012
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        atl: Computerized classification of proximal occlusion in the left anterior descending coronary artery.
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        au:
          Gregg RE
          Nikus KC
          Zhou SH
          Startt Selvester RH
          Barbara V
          Gregg, Richard E
          Nikus, Kjell C
          Zhou, Sophia H
          Startt Selvester, Ronald H
          Barbara, Victoria
        affil: Advanced Algorithm Research Center, Philips Healthcare, Thousand Oaks, CA, USA
      sug:
        subj:
          Coronary Stenosis Diagnosis
          Coronary Stenosis Epidemiology
          Diagnosis, Computer Assisted Methods
          Electrocardiography Methods
          Aged
          California
          Diagnosis, Computer Assisted Statistics and Numerical Data
          Electrocardiography Statistics and Numerical Data
          Female
          Human
          Male
          Middle Age
          Observer Bias
          Prevalence
          Reproducibility of Results
          Sensitivity and Specificity
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Proximal occlusion within the left anterior descending (LAD) coronary artery in patients with acute myocardial infarction leads to higher mortality than does nonproximal occlusion. We evaluated an automated program to detect proximal LAD occlusion. All patients with suspected acute coronary syndrome (n = 7,710) presenting consecutively to the emergency department of a local hospital with a coronary angiogram–confirmed flow-limiting lesion and notation of occlusion site were included in the study (n = 711). Electrocardiograms (ECGs) that met ST-segment elevation myocardial infarction (STEMI) criteria were included in the training set (n = 183). Paired angiographic location of proximal LAD and ECGs with ST elevation in the anterolateral region were used for the computer program development (n = 36). The test set was based on ECG criteria for anterolateral STEMI only without angiographic reports (n = 162). Tested against 2 expert cardiologists' agreed reading of proximal LAD occlusion, the algorithm has a sensitivity of 95% and a specificity of 82%. The algorithm is designed to have high sensitivity rather than high specificity for the purpose of not missing any proximal LAD in the STEMI population. Our preliminary evaluation suggests that the algorithm can detect proximal LAD occlusion as an additional interpretation to STEMI detection with similar accuracy as cardiologist readers.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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