Prognostic importance of new small Q waves following Non-ST-Elevation acute coronary syndromes
| Autor: | Kenneth W. Mahaffey, A. Michael Lincoff, John H. Alexander, Olle Pahlm, E. Magnus Ohman, Galen S. Wagner, Maarten L. Simoons, Robert A. Harrington, Robert M. Califf, Jaap W. Deckers, Manju Bhapkar, Peter Klootwijk, Bo Henden |
|---|---|
| Přispěvatelé: | Cardiology |
| Rok vydání: | 2003 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Myocardial Infarction Eptifibatide Angiotensin-Converting Enzyme Inhibitors Coronary Disease Coronary Angiography Electrocardiography Ventricular Dysfunction Left QRS complex Internal medicine Confidence Intervals Myocardial Revascularization Odds Ratio medicine Creatine Kinase MB Form Humans ST segment Myocardial infarction Creatine Kinase Aged Heart Failure medicine.diagnostic_test business.industry ST elevation Syndrome General Medicine Middle Aged Prognosis medicine.disease Survival Analysis Isoenzymes Survival Rate Acute Disease Cardiology Platelet aggregation inhibitor Female Myocardial infarction diagnosis Peptides business Platelet Aggregation Inhibitors |
| Zdroj: | American Journal of Medicine, 115, 613-619. Elsevier Inc. |
| ISSN: | 1555-7162 0002-9343 |
| Popis: | PURPOSE: To investigate the prognostic importance of new small Q waves following an acute coronary syndrome. METHODS: We assessed 6-month mortality in 10,501 patients with non-ST-elevation acute coronary syndromes who had survived 30 days and had both admission and 30-day electrocardiograms. Patients were stratified by whether they had no new Q waves (n = 9447), new 30- to 40-ms Q waves (n = 733), or new ≥40-ms Q waves (n = 321). RESULTS: Mortality was higher in patients with 30- to 40-ms Q waves than in those with no new Q waves (3.4% [25/733] vs. 2.4% [227/9447], P = 0.005), and even higher in those with ≥40-ms Q waves (5.3% [17/321], P = 0.002). After adjustment for baseline risk predictors, mortality remained higher in patients with new 30- to 40-ms Q waves (odds ratio [OR] = 1.30; 95% confidence interval [CI]: 0.85 to 1.98; P = 0.23) and those with new ≥40-ms Q waves (OR = 1.87; 95% CI: 1.13 to 3.09; P = 0.01). CONCLUSION: Patients with new small Q waves following a non-ST-elevation acute coronary syndrome are at increased risk of adverse outcomes. These small Q waves should be considered diagnostic of myocardial infarction. Further research should investigate whether even smaller QRS changes are prognostically important. |
| Databáze: | OpenAIRE |
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