Document Detail

Improvement of risk-stratification by use of a new combination of Holter variables in survivors of myocardial infarction.
MedLine Citation:
PMID:  12470395     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Holter monitoring is one option in risk-stratification after acute myocardial infarction (MI). Measurements of heart rate variability (HRV), ventricular tachycardia (VT) and ST-segment elevation (ST upward arrow ) have been useful in predicting clinical outcome. We investigated if a combination of different Holter variables could optimize risk-stratification. DESIGN: One hundred and twenty-one men < 70 years old with a first MI were studied. Holter monitoring for 24 h was started 11 +/- 5 days after MI and analysed for HRV, VT and ST. Follow-up was 10-12 years with cardiac death as endpoint. RESULTS: Thirty-six patients were positive for > or = 1 Holter variable (HRV in 15, VT in 16, ST in 10). At follow-up 22 cardiac deaths had occurred. The prognostic sensitivity of individual Holter variables ranged from 23 to 36%, but increased to 64% if combined. The cardiac death rate in Holter positive patients (39%) was significantly higher than in Holter negative patients (9%) (p < 0.0001). CONCLUSION: By combining measurements of HRV, VT and ST the prognostic importance of Holter monitoring can be significantly improved. The patients can be stratified in a low-risk group with an annual mortality < 1% vs a high-risk group with a cardiac death rate around 40% over the following decade.
Axel Vittrup; Allan Johansen; Mogens Møller; Hans Mickley
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  36     ISSN:  1401-7431     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-12-09     Completed Date:  2003-03-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  Norway    
Other Details:
Languages:  eng     Pagination:  282-6     Citation Subset:  IM    
Department of Cardiology, Odense University Hospital, Odense, Denmark.
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MeSH Terms
Angioplasty, Transluminal, Percutaneous Coronary
Coronary Artery Bypass
Death, Sudden, Cardiac / epidemiology,  etiology
Electrocardiography, Ambulatory*
Follow-Up Studies
Heart Rate / physiology
Middle Aged
Myocardial Infarction / diagnosis,  epidemiology*,  therapy
Observer Variation
Predictive Value of Tests
Risk Factors
Sensitivity and Specificity
Survival Analysis
Tachycardia, Ventricular / diagnosis,  epidemiology,  therapy
Comment In:
Scand Cardiovasc J. 2002 Sep;36(5):259-61   [PMID:  12470390 ]

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

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