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BET 2: should ST elevation be measured at the J point or 60 ms later?


A shortcut systematic review was carried out to establish whether in patients with suspected acute coronary syndromes presenting to the emergency department, measurement of electrocardiographic ST elevation at the J point or 60 ms after the J point will lead to more accurate identification of patients with acute coronary occlusion who may benefit from immediate coronary revascularisation. Three studies were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the current evidence does not justify a shift away from measurement of ST elevation at the J point, as advocated in international guidance. Due to the limited available evidence, however, further research in this area is necessary.

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