Document Detail


Clinical significance and prognostic importance of left ventricular hypertrophy in non-Q-wave acute myocardial infarction.
MedLine Citation:
PMID:  2973215     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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)
Authors:
W E Boden; R E Kleiger; K B Schechtman; R J Capone; D J Schwartz; R S Gibson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  The American journal of cardiology     Volume:  62     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1988 Nov 
Date Detail:
Created Date:  1988-12-02     Completed Date:  1988-12-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1000-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, Harper Hospital/Detroit Medical Center, Michigan 48201.
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MeSH Terms
Descriptor/Qualifier:
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:
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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