Introduction:

Wellens' syndrome is equivalent to acute coronary syndrome with ST-segment elevation. It includes two electrocardiographic patterns suggesting a critical lesion in the anterior descending artery.

Objective:

Evaluate probable factors associated to Wellens' syndrome in patients with acute coronary syndrome without ST-segment elevation and significant coronary lesions in the anterior descending artery.

Methods:

A cross-sectional observational analytical study was conducted of patients diagnosed with acute coronary syndrome without ST-segment elevation and significant lesion in the anterior descending artery verified by coronary arteriography, admitted to the intensive coronary care unit at Manuel Fajardo Clinical Surgical Hospital in the period 2016-2019.

Results:

Mean age was 66 years, with a predominance of the male sex (53.9%) and a history of hypertension (89.5%). Patients with Wellens' syndrome had a significantly lower percentage of ischemic heart disease antecedents (58.1% vs. 84.8%; p = 0.012). A very significant statistical association was observed between the syndrome and active smoking (51.2% vs. 15.2%; p < 0.01). A significant statistical relationship was not found between Wellens' syndrome and angiographic results.

Conclusions:

The presence of electrocardiographic patterns of Wellens' syndrome is associated to smoking in patients with acute coronary syndrome without ST-segment elevation and coronary lesions in the anterior descending artery, whereas their absence is associated to a history of ischemic heart disease in the same subgroup of individuals.

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