Document Detail

Frequency and outcomes of transient myocardial ischemia in critically ill adults admitted for noncardiac conditions.
MedLine Citation:
PMID:  14619356     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Critically ill adults admitted for noncardiac conditions are at risk for acute myocardial ischemia. OBJECTIVES: To detect myocardial ischemia and injury in patients admitted for noncardiac conditions and to examine the relationship of myocardial ischemia, injury, and acuity to cardiac events. METHODS: Transient myocardial ischemia, acuity, elevations in serum troponin I, and in-hospital cardiac events were examined in 76 consecutive patients. Transient myocardial ischemia, determined by using continuous electrocardiography, was defined as a 1-mm (0.1-mV) change in ST level from baseline to event in 1 or more leads lasting 1 or more minutes. Acuity was determined by scores on Acute Physiology and Chronic Health Evaluation II. RESULTS: A total of 37 ischemic events were detected in 8 patients (10.5%); 32 (86%) were ST-segment depressions, and 35 (96%) were silent. Twelve patients (15.8%) had elevated levels of troponin I. Transient myocardial ischemia, elevated troponin I levels, and advanced age were significant predictors of cardiac complications (R2 = 0.387, F = 15.2, P < .001). Acuity correlated only modestly with increased length of stay in the intensive care unit (r = 0.26, P = .02) and elevated troponin I levels (r = 0.25, P = .03). Patients with transient myocardial ischemia had significantly higher rates of elevations in troponin I (P < .001) and cardiac events (P < .001) than did patients without. CONCLUSIONS: Transient myocardial ischemia and advanced age are predictors of cardiac events and may indicate patients at risk for cardiac events.
Kathy J Booker; Karyn Holm; Barbara J Drew; Dorothy M Lanuza; Frank D Hicks; Tim Carrigan; Michelle Wright; John Moran
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of critical care : an official publication, American Association of Critical-Care Nurses     Volume:  12     ISSN:  1062-3264     ISO Abbreviation:  Am. J. Crit. Care     Publication Date:  2003 Nov 
Date Detail:
Created Date:  2003-11-17     Completed Date:  2004-04-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9211547     Medline TA:  Am J Crit Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  508-16; discussion 517     Citation Subset:  IM; N    
Millikin University, Decatur, Ill., USA.
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MeSH Terms
Age Factors
Aged, 80 and over
Chi-Square Distribution
Coronary Artery Disease / diagnosis,  epidemiology
Critical Illness
Intensive Care Units
Multivariate Analysis
Myocardial Ischemia / diagnosis*,  epidemiology*
Risk Factors
Troponin I / blood
Reg. No./Substance:
0/Troponin I

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