| Clinical significance and prognostic importance of left ventricular hypertrophy in non-Q-wave acute myocardial infarction. | |
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MedLine Citation:
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PMID: 2973215 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Left ventricular (LV) hypertrophy is known to be an independent risk factor for cardiac death, but its significance in non-Q-wave acute myocardial infarction (AMI) has not been assessed previously. In a randomized diltiazem-placebo-controlled therapeutic trial of non-Q-wave AMI confirmed by creatine kinase-MB (CK-MB), 126 of 544 patients (23%) exhibited LV hypertrophy using standard voltage criteria. Compared to patients without LV hypertrophy, patients with LV hypertrophy were significantly older (65 vs 60 years, p less than 0.0001) and had smaller peak adjusted CK levels (490 +/- 376 vs 666 +/- 726 IU/liter, p less than 0.001) than patients without LV hypertrophy. Patients with and without LV hypertrophy did not differ significantly in acute mortality during hospitalization, progression to Q waves, reinfarction by CK-MB criteria or angina associated with transient electrocardiographic changes. Compared with patients without LV hypertrophy, those patients with non-Q-wave AMI and LV hypertrophy had a 2-fold higher incidence of reinfarction (24 vs 12%, p less than 0.005) and death (19 vs 9%, p = 0.044) during the first year of follow-up. Multivariate regression analysis revealed that the relative risk of death and reinfarction during the initial year after AMI was increased by a factor of 1.7 and 2.1 among patients with LV hypertrophy, respectively. It was therefore concluded that, although patients with LV hypertrophy and non-Q-wave AMI have smaller enzymatic infarcts and the same short-term prognosis as do patients without LV hypertrophy, their reinfarction and mortality rates are significantly increased during the first year of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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W E Boden; R E Kleiger; K B Schechtman; R J Capone; D J Schwartz; R S Gibson |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: The American journal of cardiology Volume: 62 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1988 Nov |
Date Detail:
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Created Date: 1988-12-02 Completed Date: 1988-12-02 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1000-4 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine, Harper Hospital/Detroit Medical Center, Michigan 48201. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Age Factors Cardiomegaly / mortality* Clinical Trials as Topic Creatine Kinase / blood Diltiazem / therapeutic use Electrocardiography Humans Isoenzymes Myocardial Infarction / drug therapy, mortality* Prognosis Random Allocation Regression Analysis Retrospective Studies Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Isoenzymes; 42399-41-7/Diltiazem; EC 2.7.3.2/Creatine Kinase |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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