Comparison of the prognostic role of Q waves and inverted T waves in the presenting ECG of STEMI patients.

Autor:	Koivula K; South Karelia Central Hospital, Lappeenranta, Finland.; Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland., Nikus K; Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.; Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland., Viikilä J; Cardiology, Helsinki University Central Hospital, Helsinki, Finland., Lilleberg J; Department of Internal Medicine, Hyvinkää Hospital, Hyvinkää, Finland., Huhtala H; Faculty of Social Sciences, University of Tampere, Tampere, Finland., Birnbaum Y; The Section of Cardiology, The Department of Medicine, Baylor College of Medicine, Houston, Texas., Eskola M; Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland.; Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland.
Jazyk:	angličtina
Zdroj:	Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc [Ann Noninvasive Electrocardiol] 2019 Jan; Vol. 24 (1), pp. e12585. Date of Electronic Publication: 2018 Sep 06.
DOI:	10.1111/anec.12585
Abstrakt:	Background: Both Q waves and T-wave inversion (TWI) in the presenting ECG are associated with a progressed stage of myocardial infarction, possibly with less potential for myocardial salvage with reperfusion therapy. Combining the diagnostic information from the Q- and T-wave analyses could improve the prognostic work-up in ST-elevation myocardial infarction (STEMI) patients. Methods: We sought to determine the prognostic impact of Q waves and TWI in the admission ECG on patient outcome in STEMI. We formed four groups according to the presence of Q waves and/or TWI (Q+TWI+; Q-TWI+; Q+TWI-; Q-TWI-). We studied 627 all-comers with STEMI derived from two patient cohorts. Results: The patients with Q+TWI+ had the highest and those with Q-TWI- the lowest 30-day and one-year mortality. One-year mortality was similar between Q-TWI+ and Q+TWI-. The survival analysis showed higher early mortality in Q+TWI- but the higher late mortality in Q-TWI+ compensated for the difference at 1 year. The highest peak troponin level was found in the patients with Q+TWI-. Conclusion: Q waves and TWI predict adverse outcome, especially if both ECG features are present. Q waves and TWI predict similar one-year mortality. Extending the ECG analysis in STEMI patients to include both Q waves and TWI improves risk stratification. (© 2018 Wiley Periodicals, Inc.)
Databáze:	MEDLINE
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