Key result
An ECG pattern of ST elevation <2 mm and negative T waves 12 hours post-MI predicted a higher rate of recurrent ischemia than patterns with ST elevation >2 mm (79.2% vs 33.3% and 14.8%, p<0.0001).
Why the study?
Does the electrocardiographic pattern at 12 hours after admission predict recurrent ischemia in patients with acute Q-wave myocardial infarction?
Cohort (n=140)
Does the electrocardiographic pattern at 12 hours after admission predict recurrent ischemia in patients with acute Q-wave myocardial infarction?
p-value: p=< 0.0001
An ECG pattern of ST elevation < 2 mm and negative T waves at 12 hours after acute Q-wave MI identifies patients with smaller infarctions but a higher risk of recurrent ischemia.
May warrant intensified post-MI monitoring in this ECG subgroup; hypothesis-generating and requires prospective validation before guiding practice.
A total of 140 consecutive patients with acute Q-wave myocardial infarction was evaluated to assess the relationship between different electrocardiographic patterns of evolution and the incidence of recurrent ischemia within 10 days of infarction. Patients were allocated to three groups according to the electrocardiogram at 12 h after admission: Group A: ST elevation of < 2 mm and negative T waves (75 patients); Group B: ST elevation of > 2 mm and negative T waves (35 patients); Group C: ST elevation of > 2 mm and positive T waves (30 patients). Patients in Group C had more anterior wall infarctions (82%) than Group A (40%) or Group B (58%) (p = 0.0001). Peak creatine kinase levels were lower in Group A (782 +/- 115 IU) than in Groups B (1415 +/- 257 IU) and C (1501 +/- 287 IU) (p < 0.0001). The occurrence of post-infarction recurrent ischemia was more frequent in Group A (79.2%) than in Groups B (33.3%) and C (14.8%) (p < 0.0001). Patients in Group A had relatively smaller infarctions and a higher incidence of recurrent ischemia, whereas patients in Group C had larger infarctions and a lower incidence of recurrent ischemia. The electrocardiographic pattern 12 h after admission for acute myocardial infarction is helpful in identifying a subgroup at high risk of recurrent ischemia.
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Benjaminov et al. (1995) conducted a cohort in acute Q-wave myocardial infarction (n=140). ECG pattern of ST elevation < 2 mm and negative T waves vs. ECG patterns with ST elevation > 2 mm was evaluated on post-infarction recurrent ischemia within 10 days (p=< 0.0001). An ECG pattern of ST elevation <2 mm and negative T waves 12 hours post-MI predicted a higher rate of recurrent ischemia than patterns with ST elevation >2 mm (79.2% vs 33.3% and 14.8%, p<0.0001).
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