The prognostic significance of early and late right precordial lead (V4R) ST‐segment elevation in patients with acute anterior myocardial infarction

Background The predictive significance of ST‐segment elevation (STE) in lead V4R in patients with anterior ST‐segment elevation myocardial infarction (STEMI) has not been well‐understood. In this study, we evaluated the prognostic value of early and late STE in lead V4R in patients with anterior STEMI. Methods A total 451 patients with anterior STEMI who treated with primary percutaneous coronary intervention (PPCI) were prospectively enrolled in this study. All patients were classified according to presence of STE (>1 mm) in lead V4R at admission and/or 60 min after PPCI. Based on this classification, all patients were divided into three subgroups as no V4R STE (Group 1), early but not late V4R STE (Group 2) and late V4R STE (Group 3). Results In‐hospital mortality had higher rates at group 2 and 3 and that had 2.1 and 4.1‐times higher mortality than group 1. Late V4R STE remained as an independent risk factor for cardiogenic shock (odds ratio [OR] 2.6; 95% confidence interval [CI] 1.9–4.3; p