Non-ST Segment Elevation Acute
Myocardial Infarction (NSTEMI) is one of the spectrums
of Acute Coronary Syndrome (ACS) with a high mortality
rate. Patients with NSTEMI require early risk
stratification to define invasive strategy.
Electrocardiography (ECG) has been proven useful for
detecting cardiac abnormalities due to ACS. One of the
ECG parameters used is the P wave peak time. The
severity of myocardial ischemia or infarction is
determined by the lesion of coronary artery and can be
measured based on the SYNTAX score. This study aimed
to determine the relationship between the P wave peak
time and the SYNTAX score.
Method: This is a cross-sectional study of NSTEMI
patients who underwent angiography at the Adam Malik
Hospital from July 2020 to June 2021. Measurements of P
wave peak time on ECG were made in leads II and V1.
The SYNTAX score was calculated based on the results of
the angiography. Bivariate analysis was conducted to
assess the correlation between the two variables. Then,
ROC analysis was performed to assess the wave peak time
as a predictor of coronary lesion severity.
Result: Total subjects were 60 NSTEMI patients consist
of 37 (61.66%) patients with severe coronary lesions
(SYNTAX score < 23) and 23 (38.33%) patients with nonsevere coronary lesions (SYNTAX score 23). There is a
moderate positive correlation between the P wave peak
time and the SYNTAX score in lead II (r = 0.449; p <
0.001) and in lead V1 (r = 0.405; p = 0.001). Based on ROC
analysis, the P wave peak time can predict the severity of
coronary lesions with AUC = 0.71 in lead II and AUC =
0.68 in lead V1.
Conclusion: The P wave peak time on the ECG has a
correlation with the SYNTAX score and can predict the
severity of coronary lesions in NSTEMI patients.
Keywords : NSTEMI, P Wave, SYNTAX Score, Coronary Lesion.