Diagnostic agreement of smartphone-based electrocardiogram with coronary angiography in identifying vessel involvement in patients with myocardial infarction

Abstract

Background: Acute myocardial infarction (MI) remains one of the major causes of morbidity and mortality throughout the world. The objectives of this study were to determine the diagnostic agreement between the findings from Portable (Spandan Pro) and Conventional Electrocardiogram with coronary angiography (CAG) regarding vessel involvement in MI patients, and to assess related risk factors. Methodology: This study was an Observational, Single-arm, Cross-sectional study performed on 109 subjects at a local hospital in Dehradun. The study was approved by the Institutional Ethics Committee, and informed consent was obtained from all the participants. For diagnostic agreement, Statistical analyses such as Cohen's κ, weighted κ, prevalence- and bias-adjusted κ (PABAK), and Jaccard index were used. Results: The mean age of the included patients was 58 ± 11.96 years, with a significant male predominance (88.07%). For overall vessel involvement of ECGs with CAG, portable ECG showed a higher sensitivity (84.76 vs. 78.10%), and for LAD artery, it also showed higher sensitivity (88.46% vs. 82.05%) compared to the conven tional ECG. Diagnostic agreement showed substantial agreement with CAG (PABAK 0.68), and according to the Jaccard Index, there was a moderate agreement (approximately 50%) between the ECG-derived findings with CAG across all types of vessel diseases. The most prevalent confounding factor among the participants was smoking (41.9%), followed by Hypertension (39.0%) and diabetes (34.3%). Conclusion: This study indicates that Portable ECG performed comparably to conventional ECG and had a moderate level of diagnostic agreement with CAG in the detection of vessel involvement in patients with MI.