© 2003 by BMJ Publishing Group & British Cardiac Society
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Ischaemic heart disease
"High take off" ST segments do not carry an adverse prognosis 
First described in 1936, this study confirms that early repolarisation (high take-off) is more common in men, blacks (48% v 26% with a normal ECG), and in people who take more exercise (10.4 hours per week of activity v 6.4 hours). It is not associated with any increase in mortality, and patients with this pattern appear to have fewer arrhythmias. The danger lies in this normal variant being interpreted as acute myocardial infarction in the era of 30 minute door-to-needle thrombolysis targets.
Klatsky AL, Oehm R, Cooper RA, Udaltsova N, Armstrong MA. The early repolarization normal variant electrocardiogram: correlates and consequences. Am J Med 2003;115:171–7.[CrossRef][Medline]
Primary angioplasty is better than thrombolysis A total of 1572 patients with acute myocardial infarction were randomised with angioplasty or accelerated treatment with intravenous alteplase. Among patients who underwent randomisation
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