on llll|1o Optimizing the initial 12-lead electrocardiographic diagnosis of acute myocardial infarction

Aims The optimum definition of ST elevation for diagnosis of acute myocardial infarction, with respect to both the minimum height and the minimum numbers of leads, is unknown. Furthermore, only 50/o of patients with acute myocardial infarction present with ST elevation. We thus quantified the sensitivity and specificity of different ST elevation criteria for diagnosis of acute myocardial infarc-tion, and determined whether models incorporating mul-tiple QRST features in addition to ST elevation, could improve detection of acute myocardial infarction. Methods and Results The study population comprised ll90 subjects: 1041 consecutive patients presenting with chest pain (335 with acute myocardial infarction) and 149 controls without chest pain. Subjects were randomly divided into a training set (587) and a validation set (603)