Document Detail


Usefulness of standard electrocardiographic parameters for predicting cardiac events after acute myocardial infarction during modern treatment era.
MedLine Citation:
PMID:  12127604     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Comprehensive information about the independent value of different electrocardiographic (ECG) variables in predicting cardiac events after acute myocardial infarction (AMI) in the era of modern therapy is limited. Patients (n = 1,034) underwent standard electrocardiography from 5 to 7 days after an AMI. Several time intervals and PQRST abnormalities were analyzed from the electrocardiogram. During a mean +/- SD follow-up of 752 +/- 301 days on average, 42 patients (4%) experienced cardiac death, and 259 patients (25%) a cardiac death, nonfatal AMI, or unstable angina. Several ECG variables had a significant association with cardiac events in univariate comparisons. After adjustment for all risk variables in the Cox hazards model, lateral ST-segment depression (hazard ratio [HR] 4.76, 95% confidence interval [CI] 2.40 to 9.44, p <0.0001) and atrial abnormality with a terminal deflection of the P wave > or =0.1 mV deep and > or =40 ms in duration in lead V(1) (HR 2.46, 95% CI 1.25 to 4.82, p = 0.009) were the only ECG variables that independently predicted cardiac death. Lateral ST-segment depression also predicted the combined end point of cardiac death/nonfatal AMI/unstable angina in this model (HR 1.49, 95% CI 1.14 to 1.94, p = 0.003). In conclusion, lateral ST depression and atrial abnormality on the electrocardiogram are independent predictors of cardiac death after AMI. Lateral ST depression is also associated with ischemic cardiac events.
Authors:
Juha S Perkiomaki; Wojciech Zareba; Henry M Greenberg; Arthur J Moss;
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  90     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2002 Aug 
Date Detail:
Created Date:  2002-07-19     Completed Date:  2002-08-27     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  205-9     Citation Subset:  AIM; IM    
Affiliation:
Cardiology Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, New York 14642, USA.
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MeSH Terms
Descriptor/Qualifier:
Electrocardiography*
Female
Humans
Male
Middle Aged
Myocardial Infarction / mortality,  physiopathology*
Prognosis
Risk Factors
Grant Support
ID/Acronym/Agency:
5R01 HL-48259/HL/NHLBI NIH HHS

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