| Improvement of risk-stratification by use of a new combination of Holter variables in survivors of myocardial infarction. | |
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MedLine Citation:
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PMID: 12470395 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Axel Vittrup; Allan Johansen; Mogens Møller; Hans Mickley |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Scandinavian cardiovascular journal : SCJ Volume: 36 ISSN: 1401-7431 ISO Abbreviation: Scand. Cardiovasc. J. Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-12-09 Completed Date: 2003-03-28 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 9708377 Medline TA: Scand Cardiovasc J Country: Norway |
Other Details:
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Languages: eng Pagination: 282-6 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Odense University Hospital, Odense, Denmark. axelvittrup@dadlnet.dk |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary Coronary Artery Bypass Death, Sudden, Cardiac / epidemiology, etiology Electrocardiography, Ambulatory* Follow-Up Studies Heart Rate / physiology Humans Male Middle Aged Myocardial Infarction / diagnosis, epidemiology*, therapy Observer Variation Predictive Value of Tests Prognosis Risk Factors Sensitivity and Specificity Survival Analysis Tachycardia, Ventricular / diagnosis, epidemiology, therapy |
| Comments/Corrections | |
Comment In:
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Scand Cardiovasc J. 2002 Sep;36(5):259-61
[PMID:
12470390
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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