Document Detail

Prognosis in acute myocardial infarction: comparison of patients with diagnostic and nondiagnostic electrocardiograms.
MedLine Citation:
PMID:  7572576     Owner:  NLM     Status:  MEDLINE    
Prognosis in acute myocardial infarction has been compared in patients with and without diagnostic ECGs. Of 817 patients, 89.4% had ST elevation, 2.4% had left bundle branch block, and 8.2% had no ST elevation. Patients without ST elevation had a hospital mortality rate of 3.0% compared with 14.0% and 40.0%, respectively, in patients with ST elevation and left bundle branch block (p = 0.0001). Event-free survival at 6 months in patients without ST elevation was 85.6% (74.1% to 92.3%), compared with 72.9% (69.4% to 76.0%) and 31.0% (12.0% to 52.3%) in patients with ST elevation and left bundle branch block (p < 0.001). The excess risk associated with ST elevation was largely attributable to the severity of infarction: after adjustment for Q-wave development and heart failure, the hazard ratio fell from 2.24 (1.43 to 4.38) to 1.76 (0.86 to 3.59). In conclusion, acute myocardial infarction has a considerably better prognosis when it is unassociated with ST elevation or left bundle branch block. This finding may have important implications for interventional management.
K Laji; P Wilkinson; K Ranjadayalan; A D Timmis
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  130     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1995 Oct 
Date Detail:
Created Date:  1995-10-31     Completed Date:  1995-10-31     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  705-10     Citation Subset:  AIM; IM    
Department of Cardiology, London Chest Hospital, United Kingdom.
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MeSH Terms
Bundle-Branch Block / complications
Heart Conduction System
Middle Aged
Myocardial Infarction / complications,  drug therapy,  mortality*,  physiopathology
Proportional Hazards Models
Prospective Studies
Survival Analysis
Survival Rate
Thrombolytic Therapy
Treatment Outcome

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

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