Analysis of risk factors of nonischemic ST-segment elevation in patients with electrocardiographic left ventricular high voltage

Background ST-segment elevation(STE)was an important but neglected sign in patients with electrocardiographic left ventricular high voltage(LVHV),which might lead to a mistaken diagnosis of ST-segment elevation myocardial infarction(STEMI).The aim of this study was to investigate risk factors associated with STE in patients with LVHV.Methods A total of 1,590 inpatients(including 81 cases with ST-segment elevation and1509 cases with non-ST segment elevation)with electrocardiographic LVHV without confounding factors(such as myocardial infarction)were enrolled in this study.The 81 ST-segment elevation(STE)cases were assigned to the STE group while 87 out of the 1509 non-ST segment elevation(non-STE)cases were randomly selected and assigned to the non-STE group.Data on potential risk factors and patients’characteristics were collected.Logistic regression analysis and receiver operating characteristic curve(ROC)were used to identify the risk of STE in patients with LVHV.Results The mean age of the 168 studied cohort(119 males,70.83%)was 62.33±16.27 years.The two groups did not differ with regard to gender(male)and age(P=0.420 and P=0.795,respectively).Multivariate analysis showed that stroke,infection,and the value of SV1+RV5 were significantly associated with STE secondary to LVHV.The area under the curve(AUC)showed that the optimal value of SV1+RV5 cut-off for predicting STE in patients with LVHV was 4.805(sensitivity:40.74%,specificity:80.46%,AUC:0.634,95%CI:0.550-0.719,P<0.05).Conclusions A value of SV1+RV5 more than 4.8 m V,stroke,and infection are independent risk factors associated with non-ischemic STE in patients with electrocardiographic LVHV.