Document Detail


A new epidemiologic classification system for interim myocardial infarction from serial electrocardiographic changes.
MedLine Citation:
PMID:  2773788     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Many clinical trials or population studies have used change in Minnesota Q code, ST-segment depression code or T-wave inversion code as evidence of new myocardial infarction or new coronary heart disease event. Direct electrocardiogram (ECG) waveform comparison is a new standardized procedure for diagnosing interim myocardial infarction from ECGs classified according to the Minnesota code (serial Q-wave pattern change). This procedure was investigated for its application in epidemiologic studies. Use of this procedure in the Multiple Risk Factor Intervention Trial resulted in a 50% increase in the positive predictive accuracy, improved agreement with clinically defined myocardial infarction and a strong independent prognostic association with total and coronary heart disease mortality. Among those with major Minnesota Q-code findings, there was substantial variation in mortality. The 5-year coronary heart disease death rates estimated by life table analysis were 8.5% for those with major serial Q-wave pattern change, 5.1% for those with minor serial Q-wave pattern change and 1.5 to 2.6% for those with major or minor Minnesota Q-code change not substantiated by direct waveform comparison, compared with 2.4% for those with no Minnesota Q-code findings. The coronary heart disease death rate for those with major serial Q-wave pattern change was greater than that for the other ECG groups (p less than 0.01). Adjustment for age and other risk factors did not qualitatively alter these findings. This new approach is eminently suitable for export to other investigators, for incorporation into computer analysis programs and for statistical analysis.
Authors:
R S Crow; R J Prineas; D R Jacobs; H Blackburn
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  64     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-05     Completed Date:  1989-10-05     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:  454-61     Citation Subset:  AIM; IM    
Affiliation:
Division of Epidemiology, University of Minnesota, Minneapolis 55455.
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MeSH Terms
Descriptor/Qualifier:
Actuarial Analysis
Adult
Electrocardiography*
Epidemiologic Methods*
Humans
Male
Middle Aged
Myocardial Infarction / classification*,  mortality,  physiopathology
Grant Support
ID/Acronym/Agency:
R01HL29187/HL/NHLBI NIH HHS

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


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