Chest ACCP Education Calendar
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Guest Access | Sign In via User Name/Password
This Article
Right arrow Full Text (PDF) Free
Right arrow Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Article Archive
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Birnbaum, Y
Right arrow Articles by Gabbay, U
Right arrow Search for Related Content
PubMed
Right arrow Articles by Birnbaum, Y
Right arrow Articles by Gabbay, U

Chest, Vol 103, 1681-1687, Copyright © 1993 by American College of Chest Physicians

ARTICLES

Prognostic significance of the initial electrocardiographic pattern in a first acute anterior wall myocardial infarction

Y Birnbaum, S Sclarovsky, A Blum, A Mager and U Gabbay
Israel and Ione Massada Center for Heart Diseases, Beilinson Medical Center, Petah Tikva, Israel.

The availability of potent, but potentially dangerous, types of reperfusion therapy for acute myocardial infarction (AMI) has forced us to refine our tools for early and accurate diagnosis and for early risk stratification of patients with evolving AMI. The estimation of risk has to be made shortly after admission, when only the history, physical examination, and the ECG are available. This study was undertaken to compare in-hospital mortality with different patterns of the ECG obtained at admission in 147 consecutive patients with an evolving first AMI of the anterior wall. By using a new classification of the admission ECG, it was possible to divide the patients into 3 groups: (1) group A contained 12 patients with tall peaked T waves in the involved leads, without ST segment elevation; (2) group B comprised 77 patients with abnormal T waves and ST elevation, but without major changes in the terminal portion of the QRS complex; and (3) group C comprised 58 patients with abnormal T waves, ST elevation, and distortion of the terminal portion of the QRS. The mortality was 0, 3 percent, and 29 percent in groups A, B, and C, respectively (chi 2 = 22.91; p = 0). By using a logistic regression model, it was found that the initial ECG pattern alone is a strong predictor of in-hospital mortality in patients with an evolving anterior wall AMI. The predicted probabilities of death in groups A, B, and C are 0.0016, 0.025, and 0.29, respectively. This simple classification of the initial ECG pattern in patients with a first AMI of the anterior wall may enable the differentiation of patients with low in-hospital mortality (groups A and B) and of those with an in-hospital mortality of almost 30 percent (group C).


This article has been cited by other articles:


Home page
 HeartHome page
M Sejersten, Y Birnbaum, R S Ripa, C Maynard, G S Wagner, P Clemmensen, and for the DANAMI-2 Investigators
Influences of electrocardiographic ischaemia grades and symptom duration on outcomes in patients with acute myocardial infarction treated with thrombolysis versus primary percutaneous coronary intervention: results from the DANAMI-2 trial
Heart, November 1, 2006; 92(11): 1577 - 1582.
[Abstract] [Full Text] [PDF]

Home page
 Postgrad. Med. J.Home page
Y Birnbaum and B J Drew
The electrocardiogram in ST elevation acute myocardial infarction: correlation with coronary anatomy and prognosis
Postgrad. Med. J., September 1, 2003; 79(935): 490 - 504.
[Abstract] [Full Text]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1993 by the American College of Chest Physicians.