Effect of age and gender on diagnostic accuracy of ECG diagnosis of acute myocardial infarction

Recently published ACUESC criteria for acute MI were nor age and gender dependent. The aim of this study was to modifv the criteria by incorporating age and gender based limits of ST amplitude, together with other ST-T measures, and to assess the effect on sensitiviry erc. A database of 789 ECGs from patients presenting with acute chest pain was used to develop criteria along with 1498 ECGs from normal individuals whose ECGs were used to control specijkity. A third database of 1220 ECGs was also available as a test set. The sensitivity of the new criteria increased from 41.5% to 46.8% while specificity improved from 96% to 98.5%. Similar improvements were seen for males and females. With respect to age, specificity improved in all deciles. Sensitivity decreased slightly in the middle deciles but improved dramatically for the remainder. Age and gender based criteria markedly improved sensitivity and specificity of ECG criteria fur acute MI.