Document Detail


Heart rate variability as a means of assessing prognosis after acute myocardial infarction. A 3-year follow-up study.
MedLine Citation:
PMID:  9152649     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The present study evaluated the prognostic value of heart rate variability after acute myocardial infarction in comparison with other known risk factors. The cut-off points that maximized the hazards ratio were also explored. PATIENTS AND METHODS: Heart rate variability was assessed with 24 h ambulatory electrocardiography in 74 patients with acute myocardial infarction, 4 +/- 2 days after hospital admission and in 24 healthy controls. Patients were followed for 36 +/- 15 months. RESULTS: During follow-up, 18 patients died, nine suffered a non-fatal infarction and 20 underwent revascularization procedures. Heart rate variability was higher in survivors than in non-survivors (P = 0.005). This difference was found at higher statistical levels when comparing non-survivors vs controls (P = 0.0002). A similar statistically significant difference was also found between survivors vs controls (P = 0.04). Patients suffering non-fatal infarction and cardiac events (defined as death, non-fatal infarction or revascularization) had a lower heart rate variability than those without (P = 0.03 and P = 0.03, respectively). With multivariate regression analysis, decreased heart rate variability independently predicted mortality and death or non-fatal infarction. The presence of a left ventricular ejection fraction < 40% and a history of systemic hypertension were, however, stronger predictors. The cut-off points that maximized the hazards ratio using the Cox model differed from those reported by others. CONCLUSION: Decreased heart rate variability independently predicted poor prognosis after myocardial infarction. However, the cut-off points that should be used in clinical practice are still a matter for further investigation.
Authors:
M Quintana; N Storck; L E Lindblad; K Lindvall; M Ericson
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  18     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1997 May 
Date Detail:
Created Date:  1997-07-25     Completed Date:  1997-07-25     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  789-97     Citation Subset:  IM    
Affiliation:
Karolinska Institute, Department of Cardiology, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Cardiovascular Agents / therapeutic use
Electrocardiography, Ambulatory / statistics & numerical data*
Female
Follow-Up Studies
Heart Rate / drug effects,  physiology*
Humans
Male
Middle Aged
Myocardial Infarction / drug therapy,  mortality*,  physiopathology
Proportional Hazards Models
Risk Factors
Sensitivity and Specificity
Signal Processing, Computer-Assisted
Survival Rate
Chemical
Reg. No./Substance:
0/Cardiovascular Agents
Comments/Corrections
Comment In:
Eur Heart J. 1997 May;18(5):710-2   [PMID:  9152638 ]

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


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