Document Detail


Admission ECG predicts long-term outcome in acute coronary syndromes without ST elevation.
MedLine Citation:
PMID:  16877473     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Acute coronary syndromes (ACS) without ST elevation are a frequent cause of hospital admission, myocardial infarction and death. AIM: To explore the role of the ECG in stratifying ACS patients. DESIGN: Prospective, centrally-coordinated multicentre registry involving 56 centres throughout the UK. METHODS: Consecutive patients admitted with ACS without ST elevation on the presenting ECG (n = 1046) were followed for 6 months. A subgroup (n = 653) were flagged with the UK Office for National Statistics and followed-up for death over 4 years. RESULTS: Mean follow-up for the group as a whole was 2.4 years. In the first 6 months, the death rate was 7.3%. Survival at 1 year was 90.8% (95%CI 88.2%-92.8%); at 45 months it was 77.8% (95%CI 74.1%-81.1%). We compared data in those with ST depression or bundle branch block on the admission ECG (n = 304, 29%) with those with T wave inversion, Q waves and minor ST segment changes (n = 576, 55%) and those with a normal ECG (n = 166, 16%). Their respective incidences of death were 15%, 5% and 2% (p < 0.01) at 6 months, and 38%, 22% and 7% (p < 0.01) at 4 years. DISCUSSION: Rates of adverse events are high in patients admitted to UK hospitals with ACS without ST elevation. The ECG remains a very important and simple discriminator of both short- and long-term risk, enabling more aggressive, proven therapies to be targeted towards those at highest risk.
Authors:
J Collinson; A Bakhai; A Taneja; D Wang; M D Flather
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-07-28
Journal Detail:
Title:  QJM : monthly journal of the Association of Physicians     Volume:  99     ISSN:  1460-2725     ISO Abbreviation:  QJM     Publication Date:  2006 Sep 
Date Detail:
Created Date:  2006-08-25     Completed Date:  2007-03-19     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  9438285     Medline TA:  QJM     Country:  England    
Other Details:
Languages:  eng     Pagination:  601-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Chelsea & Westminster Hospital, 369 Fulham Road, London. julian.collinson@chelwest.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina, Unstable / mortality*
Bundle-Branch Block / epidemiology
Electrocardiography*
Female
Great Britain
Humans
Male
Microvascular Angina / mortality*
Middle Aged
Myocardial Infarction / mortality*
Prognosis
Prospective Studies
Risk Factors
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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