EBQ:Sgarbossa Criteria Study
Under Review Journal Club Article
Sgarbossa E. et al.. "Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators". NEJM. 1996. 334(8):481-7.
PubMed Full text PDF
PubMed Full text PDF
Clinical Question
How can we Diagnose Acute Myocardial Infarction in Left Bundle Branch Block patients ?
Conclusion
A Validated Clinical prediction rule has been Developed based on ECG criteria to Diagnose Acute Myocardial infarction in Left Bundle Branch Patients
Major Points
The Sgarbossa Criteria:
- ST-segment Elevation of at least 1 mm with concordance with the QRS complex
- ST-segment depression in leads V1, V2 or V3
- ST-segment Elevation of atleast 5 mm with discordance with the QRS complex
Study Design
Population
Patient Demographics
- Median Age: 68 years
- Males: 64% in study group and 60% in experimental group
- Left Axis Deviation: 28% Vs. 48%
- Previous MI: 26% Vs. 59%
Inclusion Criteria
- Experiment: Patients with LBBB and Acute myocardial infarction (GUSTO-1 trial population)[1]
- Control: Patients with normal documented angiography with LBBB Randomly selected from Duke data bank for cardiovascular disease[2]
Exclusion Criteria
Patients without LBBB
Interventions
Outcomes
Primary Outcome
Acute Myocardial Infarction
Subgroup analysis
Criticisms & Further Discussion
Funding
Grant from Bayer, Genentech, CIBA–Corning, ICI Pharmaceuticals, and Sanofi Pharmaceuticals.