December 1, 1994Coronary Artery Disease
Risk of subsequent cardiac events in stable convalescing patients after first non-Q-wave and Q-wave myocardial infarction
Key result
In stable convalescing patients after a first myocardial infarction, non-Q-wave infarction was associated with a similar rate of subsequent cardiac events compared to Q-wave infarction (16.7% vs 15.7%; P=0.29).
Why the study?
Do non-invasive ischemic tests predict subsequent cardiac events in stable convalescing patients after first myocardial infarction?
Population
549 stable, convalescing patients after their first Q-wave and non-Q-wave myocardial infarction.
Design
Cohort
Follow-up
mean 23 months
Authors
Discussion
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Implication
Similar post-MI risk after Q- and non-Q-wave events supports uniform surveillance; leaves open whether ischemic testing improves risk stratification.
Study Design
Type
Cohort (n=549)
Structured PICO
Do non-invasive ischemic tests predict subsequent cardiac events in stable convalescing patients after first myocardial infarction?
P
Population
549 stable, convalescing patients evaluated at a median of 2 months after their first Q-wave or non-Q-wave myocardial infarction, followed for a mean of 23 months.
E
Exposure
Non-invasive ischemic tests (resting ECG, exercise ECG, ambulatory ECG, and stress thallium scintigraphy) and clinical evaluation
O
Outcome
Composite of unstable angina requiring hospitalization, non-fatal reinfarction, or death from cardiac causes at mean 23-month follow-upcomposite
Main Result
Absolute Event Rate: 16.7% vs 15.7%
p-value: p=0.29
In stable patients convalescing from a first MI, clinical factors like post-infarction angina and diabetes are strong predictors of future cardiac events, whereas routine non-invasive ischemic testing does not provide additional prognostic value.
Cite This Study
Zareba et al. (1994) conducted a cohort in First Q-wave and non-Q-wave myocardial infarction (n=549). Non-Q-wave myocardial infarction vs. Q-wave myocardial infarction was evaluated on Cardiac events (unstable angina requiring hospitalization, non-fatal reinfarction, or death from cardiac causes) (p=0.29). In stable convalescing patients after a first myocardial infarction, non-Q-wave infarction was associated with a similar rate of subsequent cardiac events compared to Q-wave infarction (16.7% vs 15.7%; P=0.29).