Prognostic importance of new small Q waves following non-ST-elevation acute coronary syndromes

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Bibtex

@article{d3ff1e46d22b4da5b1119bcb2c8701d5,
title = "Prognostic importance of new small Q waves following non-ST-elevation acute coronary syndromes",
abstract = "PURPOSE: to investigate the prognostic importance of new small Q waves following an acute coronary syndrome. METHODS: We assessed 6-month mortality in 10,501 patients with non-ST-elevation acute coronary syndromes who had survived 30 days and had both admission and 30-day electrocardiograms. Patients were stratified by whether they had no new Q waves (n = 9447), new 30- to 40-ms Q waves (n = 733), or new greater than or equal to40-ms Q waves (n = 321). RESULTS: Mortality was higher in patients with 30- to 40-ms Q waves than in those with no new Q waves (3.4% [25/733] vs. 2.4% [227/9447], P = 0.005), and even higher in those with greater than or equal to40-ms Q waves (5.3% [17/321], P = 0.002). After adjustment for baseline risk predictors, mortality remained higher in patients with new 30- to 40-ms Q waves (odds ratio [OR] = 1.30; 95% confidence interval [CI]: 0.85 to 1.98; P = 0.23) and those with new greater than or equal to40-ms Q waves (OR = 1.87; 95% Cl: 1.13 to 3.09; P = 0.01). CONCLUSION: Patients with new small Q waves following a non-ST-elevation acute coronary syndrome are at increased risk of adverse outcomes. These small Q waves should be considered diagnostic of myocardial infarction. Further research should investigate whether even smaller QRS changes are prognostically important. (C)2003 by Excerpta Medica Inc.",
author = "JH Alexander and RA Harrington and M Bhapkar and KW Mahaffey and AM Lincoff and EM Ohman and P Klootwijk and Olle Pahlm and B Henden and JW Deckers and ML Simoons and RM Califf and GS Wagner",
year = "2003",
doi = "10.1016/j.amjmed.2003.08.007",
language = "English",
volume = "115",
pages = "613--619",
journal = "American Journal of Medicine",
issn = "0002-9343",
publisher = "Elsevier",
number = "8",

}