Noninvasive Risk Modeling After Myocardial Infarction*
Section snippets
METHODS
Patient population: This study included 553 patients who participated in the Post-Infarction Late Potential (PILP) study. The PILP study represents a noninterventional study to assess the prognostic value of ventricular late potentials detected by signal-averaging technique.14, 15All patients were admitted to the participating 17 hospitals with suspected acute myocardial infarction. Only male patients aged <66 years who had survived the acute period of myocardial infarction were evaluated for
RESULTS
Study population: In all, 553 patients were included in the analysis. The mean age was 53 ± 8 years (range 22 to 65). Seventy-nine patients (14.3%) had had a previous myocardial infarction. There were 249 patients (45.0%) presenting with anterior wall myocardial infarction. In 301 patients (54.4%), the site of infarction was inferior, and in the remaining 3 patients (0.5%), the site of myocardial infarction remained undefined. In 164 cases (29.7%), intravenous thrombolytic therapy was applied
DISCUSSION
In the present study, the combination of different parameters obtained from 24-hour HRV and SAECG was investigated to create a statistical model for noninvasive risk stratification after myocardial infarction. It is shown that beat-to-beat changes of heart rate together with QRS duration from the SAECG yield the best combination for prediction of serious arrhythmic events during the first 6 months after acute myocardial infarction. Based on these findings, a continuous risk model was developed
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Cited by (26)
Noninvasive risk stratification after myocardial infarction: Rationale, current evidence and the need for definitive trials
2009, Canadian Journal of CardiologyAmerican Heart Association/American College of Cardiology Foundation/Heart Rhythm Society Scientific Statement on Noninvasive Risk Stratification Techniques for Identifying Patients at Risk for Sudden Cardiac Death. A Scientific Statement From the American Heart Association Council on Clinical Cardiology Committee on Electrocardiography and Arrhythmias and Council on Epidemiology and Prevention
2008, Journal of the American College of CardiologyNoninvasive Risk Assessment Early After a Myocardial Infarction. The REFINE Study
2007, Journal of the American College of CardiologyCitation Excerpt :Test results were not disclosed to participants or their treating physicians. Participants underwent a submaximal exercise test to assess repolarization alternans (TWA) (17,22), followed by a 20- to 30-min high-resolution digital electrocardiographic (ECG) recording, from which signal-averaged QRS width (18) and Holter TWA were measured (13). Participants then underwent phenylephrine-induced baroreflex sensitivity (BRS) testing (9).
Depression in patients with acute myocardial infarction: Influence on autonomic nervous system and prognostic role. Results of a five-year follow-up study
2007, International Journal of CardiologyCitation Excerpt :The correlation of depression with other end-points than mortality has been previously tested in literature. Similarly to other authors [5–21] we observed that depression was associated with increased mortality but not with revascularization and re-AMI; this observation could support the hypothesis of the presence of an autonomic unbalance causing arrhythmia and sudden death rather than other pathophysiologic mechanisms such as platelet activation. However a recent meta-analyses of 22 studies (6367 patients) with an average follow-up of 13.7 months observed that depression was associated with higher risk for mortality and also for new cardiovascular events [18].
Utility of current risk stratification tests for predicting major arrhythmic events after myocardial infarction
2001, Journal of the American College of Cardiology
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This study was supported in part by Deutsche Forschungsgemeinschaft (DFG), Förderkennzeichen Br 759/2–2, Bonn; Bundesministerium für Forschung und Technologie (BMFT), Förderkennzeichen HKP314, Bonn; Deutscher Akademischer Austauschdienst (DAAD), Bonn, Germany; Academy of Finland (SA), Helsinki, Finland; European Union Human Capital and Mobility Programme (BIRCH-European Large Scale Facility in Biomagnetic Research at Helsinki University of Technology), Brussels, Belgium; and Franz-Loogen-Stiftung for Cardiological Research, Düsseldorf, Germany