Ischemic J waves in non-ST-elevation myocardial infarction: a pilot study on diagnostic and prognostic implications for left circumflex occlusion

초록

Objective: The J waves in an electrocardiogram (ECG) have been associated with left circumflex artery (LCX) occlusions and major adverse cardiovascular events (MACE). This study evaluated the feasibility of J wave interpretation in ECGs of non-ST-elevation myocardial infarction (NSTEMI) patients and examined its clinical significance through a pilot study. Methods: A retrospective cohort of 165 patients with angiographically confirmed LCX culprit lesions was analyzed. The patients were classified into NSTEMI without J waves (non-J-NSTEMI, n=100), NSTEMI with J waves (J-NSTEMI, n=16), and ST-elevation myocardial infarction (STEMI, n=49) groups. The in-hospital MACE rates across groups were analyzed. Results: J waves were observed in 16 patients among 116 NSTEMI patients with LCX occlusions. The incidence of inhospital MACE did not differ significantly among the STEMI (n=14, 28.4%), J-NSTEMI (n=1, 6.3%), and non-J-NSTEMI (n=22, 22.0%) groups (P=0.175). The presence of a J wave was not an independent predictor of in-hospital MACE (odds ratio, 0.445; 95% confidence interval, 0.041-4.819; P=0.506). Conclusion: Although J waves may serve as an electrocardiographic marker of LCX occlusion, their presence does not correlate with poorer clinical outcomes. Further prospective studies will be needed to validate their diagnostic and prognostic utility.

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