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Original Research | Cardiology Science | Volume 15 Issue 6, June 2026 | Pages: 1002 - 1006 | India
A Prospective Study on Predicting the Culprit Artery from Electrocardiogram in Acute St-Elevation Myocardial Infarction (STEMI) and Correlation with Coronary Angiographic Findings
Abstract: Background: Acute ST-elevation myocardial infarction (STEMI) is one of the most critical manifestations of coronary artery disease and remains a leading cause of mortality worldwide. Rapid identification of the culprit artery before coronary angiography can significantly influence treatment strategy and improve clinical outcomes. Electrocardiography (ECG) remains the fastest and most accessible diagnostic tool in acute STEMI and may provide valuable clues regarding culprit vessel localization. Materials and Methods: This prospective observational study included 100 patients diagnosed with acute STEMI admitted in the Department of Cardiology, MGM Medical College and Hospital. Detailed clinical examination, risk factor assessment, ECG analysis, and coronary angiography were performed. Patients were categorized into AWMI and IWMI groups. Various ECG markers were studied and correlated with culprit artery localization. Results: The majority of patients were male (74%), and the most affected age group was 41?60 years (52%). Hypertension (54%) and diabetes mellitus (46%) were the predominant co-morbidities. AWMI constituted 68% and IWMI constituted 32% of total cases. In AWMI, ST elevation in V1 >2.5 mm, complete RBBB, and ST elevation in aVR strongly predicted proximal LAD occlusion. In IWMI, ST elevation in V4R >1 mm and ST elevation in V1 significantly correlated with proximal RCA occlusion. Coronary angiography confirmed LAD as the most common culprit vessel. Conclusion: ECG remains a simple, rapid, and highly useful bedside modality for early prediction of culprit artery in STEMI and can assist in early intervention planning.
Keywords: STEMI, Electrocardiography, Culprit Artery, Coronary Angiography, LAD, RCA, LCX
How to Cite?: Dr. Anantrao Laxman Phad, Dr. Prashant Prabhakar Udgire, Dr. Aditya Anup Bahekar, "A Prospective Study on Predicting the Culprit Artery from Electrocardiogram in Acute St-Elevation Myocardial Infarction (STEMI) and Correlation with Coronary Angiographic Findings", Volume 15 Issue 6, June 2026, International Journal of Science and Research (IJSR), Pages: 1002-1006, https://www.ijsr.net/getabstract.php?paperid=SR26618203546, DOI: https://dx.doi.org/10.21275/SR26618203546