{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T14:42:12Z","timestamp":1785768132332,"version":"3.56.0"},"reference-count":24,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T00:00:00Z","timestamp":1731283200000},"content-version":"vor","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Noninvasive Electrocardiol"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The de Winter electrocardiogram (ECG) pattern is a rare presentation of ST\u2010segment elevation myocardial infarction (STEMI) equivalent. The clinical profile of de Winter syndrome remains to be clarified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of 1865 consecutive patients with acute myocardial infarction admitted from November 2018 to July 2023 were screened. Twelve patients (0.6%) with de Winter syndrome were included. STEMI patients whose culprit vessel was the left anterior descending artery (LAD) but without de Winter ECG pattern were selected as controls after 1:2 matching for age and sex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The de Winter syndrome patients were all male, aged 49.0 (46.3\u201352.5) years. The culprit lesion was the proximal LAD in seven patients (58.3%), the middle LAD in three (25%), the left main coronary artery in one (8.3%), and the ramus intermedius artery in the other. All of their culprit lesions had TIMI Thrombus Grade\u2009&lt;\u20094, Cohen\u2010Rentrop Score\u2009\u2264\u20092, and residual stenosis \u2265\u200980% after pretreatment with thrombus aspiration or balloon predilatation. Intracoronary imaging data were available in four patients, showing severe atherosclerotic stenosis. Compared with STEMI, de Winter syndrome had a higher prevalence of prior recurrent angina (75.0% vs. 37.5%, <jats:italic>p<\/jats:italic>\u2009=\u20090.034), better coronary collateralization (Cohen\u2010Rentrop Score: 1 vs. 0, <jats:italic>p<\/jats:italic>\u2009=\u20090.001), lower thrombus burden (TIMI grade: 1 vs. 2, <jats:italic>p<\/jats:italic>\u2009=\u20090.005) but more severe atherosclerotic stenosis in the culprit lesions (90% vs. 60%, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The culprit lesions of de Winter syndrome have a low thrombus burden, severe atherosclerotic stenosis, and poor collateral circulation protection.<\/jats:p><\/jats:sec>","DOI":"10.1111\/anec.70029","type":"journal-article","created":{"date-parts":[[2024,11,11]],"date-time":"2024-11-11T09:34:14Z","timestamp":1731317654000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Coronary Angiographic Features of de Winter Syndrome: More Than Just Occlusion of the Left Anterior Descending Artery"],"prefix":"10.1111","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8720-7965","authenticated-orcid":false,"given":"Wenyi","family":"Tang","sequence":"first","affiliation":[{"name":"Department of Cardiovascular Medicine Fifth Affiliated Hospital of Sun Yat\u2010sen University  Zhuhai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junwei","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Shenzhen Nanshan People's Hospital and the Sixth Affiliated Hospital of Shenzhen University 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