| Electrocardiographic left ventricular hypertrophy in GUSTO IV ACS: an important risk marker of mortality in women. | |
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MedLine Citation:
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PMID: 17600040 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To examine the association of left ventricular hypertrophy (LVH) on admission electrocardiography with adverse outcomes in acute coronary syndrome (ACS) patients. METHODS AND RESULTS: A total of 7443 non-ST-elevation ACS patients in Global Utilization of STrategies to Open occluded arteries (GUSTO) IV ACS trial had admission electrocardiograms analysed at a core laboratory. LVH [>or=20 mm Cornell voltage (LV voltage) (women) or >or=28 mm (men) plus strain patterns] was observed in 586 (7.9%) patients, and women accounted for 74%. LVH patients were also older and had more co-morbidities, ST-depression >or= 0.5 mm, elevated C-reactive protein and N-terminal pro-brain naturetic peptide (NT-proBNP), and lower troponin T. Invasive procedures occurred less often in LVH patients (cardiac catheterization: 31 vs. 38%, P = 0.001; percutaneous coronary intervention: 12 vs. 20%, P < 0.001). Mortality was significantly higher in patients with LVH (30 day: 5 vs. 3%, P = 0.046; 1 year: 14 vs. 7%, P < 0.001), whereas 30 day myocardial infarction (MI) and death/MI did not differ. After baseline adjustment including NT-proBNP, LVH remained associated with increased hazard of 1 year mortality in women, but not in men [P-interaction = 0.033; women: adjusted hazard ratio (LVH vs. no LVH): 1.42 (1.04-1.94), P = 0.029]. CONCLUSION: Electrocardiographic-LVH identifies an important subset of ACS patients with a higher risk of long-term mortality, particularly among women. These novel findings highlight opportunities to improve treatment and outcome among similar ACS patients. |
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Authors:
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Cynthia M Westerhout; Michael S Lauer; Stefan James; Yuling Fu; Lars Wallentin; Paul W Armstrong; |
Publication Detail:
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Type: Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't Date: 2007-06-28 |
Journal Detail:
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Title: European heart journal Volume: 28 ISSN: 0195-668X ISO Abbreviation: Eur. Heart J. Publication Date: 2007 Sep |
Date Detail:
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Created Date: 2007-09-03 Completed Date: 2008-06-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8006263 Medline TA: Eur Heart J Country: England |
Other Details:
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Languages: eng Pagination: 2064-9 Citation Subset: IM |
Affiliation:
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Canadian VIGOUR Centre Research Group, 214 Heritage Medical Research Centre, University of Alberta, Edmonton, Alberta, Canada T6G 2S2. cindy.westerhout@ualberta.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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diagnosis,
mortality*,
therapy Adult Aged Biological Markers / blood Death, Sudden, Cardiac / etiology Electrocardiography / methods* Female Heart Catheterization / statistics & numerical data Humans Hypertrophy, Left Ventricular / diagnosis, mortality*, therapy Male Middle Aged Myocardial Infarction / mortality* Prognosis Risk Factors Sex Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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