Correlation of ECG Changes with Coronary Angiographic Findings in Patients of Coronary Artery Disease

BACKGROUND Coronary Artery Disease (CAD) is the most common type of heart disease. Assessment of coronary artery disease (CAD) is the starting point of determination of prognosis of patients presenting with clinical symptoms. ECG reflects the physiology of the myocardium during ischemia, while Coronary Angiography identifies vessel anatomy. In the present study, we aimed to correlate ECG changes with coronary angiographic findings along with prediction of number of vessels involved in patients of coronary artery disease. This study also intended to determine sensitivity and specificity of ECG for diagnosis of coronary artery disease using CAG as gold standard. METHODS This cross-sectional study was carried out for a period of 2 years at Acharya Vinobha Bhave Rural Hospital, a tertiary rural health institute. 200 patients above 18 years of age who presented with or without symptoms and were willing for ECG and Angiography were included in study. Patients with valvular and congenital heart disease were excluded. Patients were divided into groups according to ECG changes and correlated with coronary angiography findings. RESULTS In the present study, the sensitivity and specificity of ECG to diagnose myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 87.50% to 96.63% and 91.30% to 95.45%, respectively. Diagnostic accuracy of ECG to detect myocardial infarction or ischemia (AWMI / AWI, IWMI / IWI, and LWMI / LWI) ranged from 89.36% to 96.40%. CONCLUSIONS ECG is used as reliable tool for the diagnosis of coronary artery disease due to its high sensitivity and specificity, though CAG is the Gold Standard method for the diagnosis of CAD.