Absence of ST-segment elevation in lead V1 predicts worse long-term outcomes in patients with first anterior ST-segment elevation myocardial infarction

Background The prognostic value of ST-segment elevation in lead V1 (STE in V1) in anterior ST-segment elevation myocardial infarction (STEMI) has not been elucidated. Methods We performed a retrospective analysis of 190 consecutive first anterior STEMI patients. STE in V1 ≥ 0.1 mV was recorded. Major adverse cardiac events (MACE) were defined as a composite of all-cause death, recurrent myocardial infarction, or target vessel revascularization. Results Among 190 patients, 42 patients did not have STE in V1. The patient without STE in V1 had a higher peak creatine kinase value and a higher incidence of 1-year MACE (36% vs. 13%, p < 0.001), driven by a higher mortality (24% vs. 5%, p < 0.001). The absence of STE in V1 was an independent predictor for 1-year MACE (odds ratio 3.16; 95% confidence interval 1.28-7.83; p = 0.01). Conclusion The absence of STE in V1 was an independent predictor for worse long-term outcomes in patients with first anterior STEMI.