Phenomenon of “de Winter” pattern, sign, or syndrome: A systematic scoping review and data analysis

Table 1 Case series and retrospective studies of de Winter pattern

Ref.	Years	Study characteristics	Comments
de Winter et al[1]	2008	Retrospective; 30/1532 AMI (2%); mean age (52 years); male (94%)	(1) 76% isolated LAD disease; (2) Culprit pLAD, PCI done; (3) Wrap-around LAD (50%); and (4) Static status1: One died (3%)
Verouden et al[2]	2009	Retrospective; 35/1855 PCI of LAD	(1) Wrap-around LAD (57%); and (2) 67% had SVD
Xu et al[9]	2018	Retrospective; 15/449 AMI (3.4%); mean age (60 years); male (87%)	(1) 11/15 underwent PCI, 2 underwent successful thrombolysis, and 2 received conservative therapy; and (2) LAD was the culprit in 9
Shahri et al[6]	2022	Case series; 11 with dW pattern; mean age (56 years); male (54%)	(1) The culprit vessel is LAD; and (2) 5 MVD
de Winter et al[10]	2019	Retrospective; 11/701 AMI (1.6%); mean age (65 years); male 91%	(1) Culprit pLAD or mLAD; and (2) PCI not in a timely fashion; 3 died (27%)
Fuji and Ikari[12]	2024	Retrospective; 2/641 ACS; mean age (69 years); male (100%)	(1) Culprit LAD; and (2) 1 patient received PCI and 1 underwent CABG
Tang et al[13]	2024	Retrospective; 12/1865 AMI; mean age (49 years); male (100%)	(1) The culprit vessel was pLAD in 7 and mLAD in 3, LMCA in 1, and 1 in the ramus intermedius artery; (2) 53% had MVD; (3) 3 developed cardiogenic shock; and (4) The median door-to-balloon time was 94.5 minutes
Alireza et al[11]	2025	Retrospective; 30/967 AMI; mean age (61 years); male (67%)	(1) Culprit pLAD treated with PCI within 90 minutes of arrival (100%); (2) Wrap-around LAD (67%); (3) MVD (60%); and (4) Mortality 3%
Chyu et al[7]	2022	Case series; 4 had STEMI equivalent, 1/4 with dW pattern	Total occlusion of LAD after the first septal branch treated with PCI
Ni[8]	2022	Case series of 10 patients (9 males)	All showed dynamic evolution (the explanation was unclear, as no full text was available) 9 had PCI

¹First electrocardiographic > > pre-procedural electrocardiographic until angiographic findings.

AMI: Acute myocardial infarction; PCI: Percutaneous coronary intervention; LAD: Left anterior descending artery; dW: De Winter; ACS: Acute coronary syndrome; STEMI: ST-elevation myocardial infarction; pLAD: Proximal segment of the left anterior descending; SVD: Single vessel disease; MVD: Multi-vessel disease; mLAD: Mid segment of the left anterior descending; CABG: Coronary artery bypass grafting.