VALIDATION OF INFARCT RELATED ARTERY PREDICTION BY CULPRIT SCORE USING ON ADMISSION ECG IN ACUTE INFERIOR WALL MI PATIENTS

Introduction: The use of ECG as a diagnostic tool is essential for locating the artery associated with the infarct is of extreme importance for individuals with inferior wall myocardial infarction to minimize the reperfusion time and risk quantication in a better way. Numerous ECG criteria have been evolved to identify infarct-related arteries. This study carries an evaluation of the present ECG criteria and focused on for validation of infarct related artery prediction by a new culprit score using on admission ECG in acute inferior wall MI patients. Total 80 patients between 2022 to 2024, were included in our study for EC Materials & Methods: G and followed by CAG analysis. The study involved 80 patients with an average age of 68 ± 10 years; 76% of the partic Results: ipants were men, and 24% were women. In our study, IWMI with LCX occlusion revealed higher depression of the ST segment for V1 to V3 along with greater ST elevation in lead II, whereas aVL indicated higher depression of ST segment with more ST elevation in lead III in IWMI with RCA occlusion. With proximal RCA occlusions V1 also showed ST elevation. After these ndings, a currently devised ECG based score named “culprit score” was used for validation of infarct related artery prediction on admission ECG in acute inferior wall MI patients followed by coronary angiography and ndings were compared. The study found that a Culprit Score value of ≤0.5 had a sensitivity of 92.11% and specicity of 90.48% for predicting proximal RCA occlusions, value 0.5 to ≤1.5 had a sensitivity of 77.27% and specicity of 89.66% for predicting distal RCA occlusions and value >1.5 had a sensitivity of 80% and specicity of 96.67% for predicting LCX occlusions. Additionally, the negative predictive value for the Culprit Score was more than 90% across the different thresholds. High specicity and NPV were found to iden Conclusion: tify the infarct-related artery in inferior wall myocardial infarction while using culprit score.