Elena Sgarbossa

Biography

• 1978-1983 MD, Facultad de Medicina de Rosario, Argentina
• Cardiology – Fundación Favaloro and Ministerio de Salud Pública; Buenos Aires, Argentina
• 1989 – Università di Bologna
• 1991-1997 Clinical cardiology research, Cleveland Clinic Foundation
• 1991-1997 Clinical cardiology research, Rush-Presbyterian Medical Center, Chicago
• Member, Editorial Board of the Journal of Electrocardiology
• Asst. Editor, Caduceus (ATA medical newsletter)

Medical Eponyms

Sgarbossa Criteria (1996)

Sgarbossa rules were proposed for the diagnosis of acute myocardial infarction in the presence of left bundle branch block. Sgarbossa Criteria can be used to assist in determining which patients with LBBB are having an AMI.

1996 – Sgarbossa proposed three absolute criteria used to diagnose AMI in patients with LBBB based on review of GUSTO-1 .

• Concordant ST elevation > 1mm in leads with a positive QRS complex (score 5)
• Concordant ST depression > 1 mm in V1-V3 (score 3)
• Excessively discordant ST elevation > 5 mm in leads with a -ve QRS complex (score 2)

These criteria are specific, but not sensitive for myocardial infarction. A total score of ≥ 3 is reported to have a specificity of 90% for diagnosing myocardial infarction.

2012 – SW Smith modified the third component of the original criteria criteria from absolute (>5mm discordant ST elevation) to proportional (any ST segment to S-wave ratio less than -0.25, with at least 1 mm ST elevation) improved prediction of acute coronary occlusion.

• ≥ 1 lead with ≥1 mm of concordant ST elevation
• ≥ 1 lead of V1-V3 with ≥ 1 mm of concordant ST depression
• ≥ 1 lead anywhere with ≥ 1 mm STE and proportionally excessive discordant STE, as defined by ≥ 25% of the depth of the preceding S-wave.

‘Replacement of the absolute ST-elevation measurement of greater than or equal to 5 mm in the third component of the Sgarbossa rule with an ST/S ratio less than -0.25 greatly improves diagnostic utility of the rule for STEMI. An unweighted rule using this criterion resulted in excellent prediction for acute coronary occlusion.’

Major Publications

• Sgarbossa EB, Topol EJ. Semantic ambiguity, the “non-” nosology and myocardial infarction. J Clin Epidemiol. 1994; 47(4): 441-6.
• Sgarbossa EB et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators. N Engl J Med. 1996; 334(8): 481-7.
• Sgarbossa EB et al. Acute myocardial infarction and complete bundle branch block at hospital admission: clinical characteristics and outcome in the thrombolytic era. GUSTO-I Investigators. Global Utilization of Streptokinase and t-PA [tissue-type plasminogen activator] for Occluded Coronary Arteries. J Am Coll Cardiol. 1998; 31(1): 105-10.
• Barbagelata A, Califf RM, Sgarbossa EB et al. Use of resources, quality of life, and clinical outcomes in patients with and without new Q waves after thrombolytic therapy for acute myocardial infarction (from the GUSTO-I trial). Am J Cardiol. 2000; 86(1): 24-9.
• Sokolove PE, Sgarbossa EB et al. Interobserver agreement in the electrocardiographic diagnosis of acute myocardial infarction in patients with left bundle branch block. Ann Emerg Med. 2000; 36(6): 566-71
• Billgren T, Birnbaum Y, Sgarbossa EB et al. Detailed definition and interobserver agreement for the electrocardiographic Sclarovsky-Birnbaum ischemia grading system. J Electrocardiol. 2002;35 Suppl:201-2.
• Billgren T, Birnbaum Y, Sgarbossa EB et al. Refinement and interobserver agreement for the electrocardiographic Sclarovsky-Birnbaum Ischemia Grading System. J Electrocardiol. 2004; 37(3): 149-56
• Barbagelata A, Califf RM, Sgarbossa EB et al. Prognostic value of predischarge electrocardiographic measurement of infarct size after thrombolysis: insights from GUSTO I Economics and Quality of Life substudy. Am Heart J. 2004; 148(5): 795-802.
• Cai Q, Mehta N, Sgarbossa EB et al. The left bundle-branch block puzzle in the 2013 ST-elevation myocardial infarction guideline: from falsely declaring emergency to denying reperfusion in a high-risk population. Are the Sgarbossa Criteria ready for prime time? Am Heart J. 2013; 166(3): 409-13.

References

• Eponymictionary. Sgarbossa Criteria history
• Eponymythology. History of the Electrocardiogram. LITFL
• Burns E. Sgarbossa Criteria. LITFL ECG Library
• Bibliography. Sgarbossa, Elena B. WorldCat Identities