Prognostic significance of ST-T segment alterations in patients with non-Q wave myocardial infarction.

J. A. Ramires, C. V. Serrano, M. C. Solimene, P. J. Moffa, B. Caramelli, F. Pileggi

Heart Institute, University of São Paulo, Brazil.

OBJECTIVE: To determine whether, among patients with non-Q wave myocardial infarction, the characteristics of the segment ST-T shifts at presentation in the diagnostic electrocardiogram can identify those with more severe coronary artery disease and predict a poor clinical outcome. DESIGN: Prospective controlled clinical trial. SETTING: Primary referral medical centre. PATIENTS: 93 patients (mean (SD) 62.0 (7.5) years) were studied: 41 with non-Q wave myocardial infarction and T wave inversion and 52 with ST segment depression. Cardiac events and mortality rates were assessed over 42 months. Age, sex, risk factors, creatinine kinase MB isoenzyme peak, and left ventricular function were comparable. RESULTS: 31 patients with T wave inversion myocardial infarction (94.6%) had total occlusion of the infarct related artery, compared with 12 patients with ST segment depression myocardial infarction (26.7%) (P < 0.05). When compared with patients with T wave inversion, patients with ST segment depression had a higher incidence of cardiac events during the first month and in the 41 subsequent months: 9.6% and 30.8% v 0% (P < 0.01) and 9.8% (P < 0.02), respectively. For the same observation periods, the mortality rates in patients with T wave inversion were 4.9% and 7.3%, and in patients with ST segment depression they were 5.8% and 9.6%, respectively. CONCLUSION: These data suggest that during a non-Q wave myocardial infarction the presence of ST segment depression is related to higher rates of short and long term cardiac events when compared with T wave inversion--possibly because of a higher incidence of residual stenosis of the infarct related artery.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

Relevant Article

Prognostic significance of ST-T segment alterations in patients with non-Q wave myocardial infarction.

S. Maeda
Heart 1997 78: 319-320. [PDF]

This article has been cited by other articles:

• Barrabes, J. A., Figueras, J., Moure, C., Cortadellas, J., Soler-Soler, J. (2000). Prognostic significance of ST segment depression in lateral leads I, aVL, V5 and V6 on the admission electrocardiogram in patients with a first acute myocardial infarction without ST segment elevation. J Am Coll Cardiol 35: 1813-1819 [Abstract] [Full Text]  
• Sgarbossa, E. B. (2000). Electrocardiogram in myocardial infarction: what is most relevant?. J Am Coll Cardiol 35: 257-257 [Full Text]