What is the clinical evidence from this study?

Study design: Cohort. Population: Acute pulmonary embolism (n=40). Intervention: Inverted T waves in ≥7 leads on admission ECG vs. Inverted T waves in ≤6 leads. Primary outcome: In-hospital complicated events (death or need for catecholamine support, cardiopulmonary resuscitation, or mechanical cardiovascular support) (OR 16.8, 95% CI 1.17-212.8, p=0.037).

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January 1, 2006Open Access

Prognostic Significance of Inverted T Waves in Patients With Acute Pulmonary Embolism

Key Result

The presence of inverted T waves in ≥7 leads on the admission ECG independently predicted in-hospital complicated events in patients with acute pulmonary embolism (OR 16.8).

Study Design

Type

Cohort (n=40)

Blinding

Single-blind

Multicenter

Structured PICO

Does the number of leads with inverted T waves predict in-hospital complicated events in patients with acute pulmonary embolism?

Population

40 patients (mean age 63 years, 62.5% female) with acute pulmonary embolism and no prior cardiopulmonary disease, evaluated retrospectively for in-hospital outcomes.

Exposure

Inverted T waves in >=7 leads on admission ECG

Comparator

Inverted T waves in <=3 leads or 4-6 leads on admission ECG

Outcome

In-hospital complicated events (composite of death, need for catecholamine support, cardiopulmonary resuscitation, or mechanical cardiovascular support)composite

The presence of inverted T waves in 7 or more leads on admission ECG is a strong independent predictor of early complications in patients with acute pulmonary embolism.

Main Result

Odds Ratio: 16.8 (95% CI 1.17–212.8)

Absolute Event Rate: 46% vs 0%

p-value: p=0.037

Limitations

Retrospective design
Single center study
Small number of patients
Low number of in-hospital deaths (only 1 patient)
Cardiac troponins or natriuretic peptides were not measured in all patients

Abstract

BACKGROUND: The significance of inverted T waves remains unclear in patients with acute pulmonary embolism (PE). METHODS AND RESULTS: The relationship of the number of leads with inverted T waves to the severity of PE in 40 patients with acute PE was studied. Patients were classified into 3 groups according to the number of leads with inverted T waves on the admission electrocardiogram (ECG): 15 patients, or=7 leads (group H). In groups L, M and H, the rates of right ventricular dysfunction on echocardiography were 47%, 92% and 100% (por=7 leads on the admission ECG (OR 16.8, p=0.037) were the only independent predictors of in-hospital complicated events. CONCLUSIONS: The number of leads with inverted T waves may be a useful and simple marker of increased risk for early complications in patients with acute PE.

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Cite This Study

Kosuge et al. (Sun,) conducted a cohort in Acute pulmonary embolism (n=40). Inverted T waves in ≥7 leads on admission ECG vs. Inverted T waves in ≤6 leads was evaluated on In-hospital complicated events (death or need for catecholamine support, cardiopulmonary resuscitation, or mechanical cardiovascular support) (OR 16.8, 95% CI 1.17-212.8, p=0.037). The presence of inverted T waves in ≥7 leads on the admission ECG independently predicted in-hospital complicated events in patients with acute pulmonary embolism (OR 16.8).

synapsesocial.com/papers/6a23f8b0003b3cd7fea62c6f https://doi.org/https://doi.org/10.1253/circj.70.750

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