Open AccessPrognosis following acute myocardial infarction in patients with ST‐T abnormalities on electrocardiograms obtained before myocardial infarction
Author(s) -
Ando Hiromi,
Yotsukura Masayuki,
Sakata Konomi,
Yoshino Hideaki,
Ishikawa Kyozo
Publication year - 2001
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960240203
Subject(s) - medicine , myocardial infarction , cardiology , t wave , hazard ratio , depression (economics) , j wave , electrocardiography , st segment , infarction , proportional hazards model , confidence interval , economics , macroeconomics
Background : Many studies have examined the relationship between prognosis after myocardial infarction (MI) and electrocardiographic (ECG) findings at the time of or after the onset of MI. However, little work has been done concerning the association between ECG findings obtained before the onset of MI (pre‐MI) and the prognosis after MI. Hypothesis : The study was undertaken to determine whether ST‐T segment and T‐wave morphology on pre‐MIECGs provides useful information for prognosis after acute MI. Methods : Pre‐MIECGs of 212 patients recorded within the 6‐month period before MI were studied for the presence of high‐voltage R waves, ST‐segment depression, and negative T waves. The Kaplan‐Meier method and multivariate analysis were used to determine the relationship between these ECG findings and in‐hospital cardiac death. Results : In‐hospital cardiac death occurred in 32 (15.1%) patients. The in‐hospital mortality rate was 38.5% (5/13) for the patients with high‐voltage R waves, 54.5% (6/11) for patients with ST‐segment depression, and 45.6% (15/33) for patients with negative T waves. The in‐hospital mortality rate was 13.6% (27/199) for patients without high‐voltage R waves, 12.9% (26/201) for patients without ST‐segment depression, and 9.5% (17/179) for those without negative T waves. Multivariate analysis identified age and negative T waves as independent risk factors for cardiac death, with a hazard ratio for negative T waves of 3.1.