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

Alexander, JH; Harrington, RA; Bhapkar, M; Mahaffey, KW; Lincoff, AM; Ohman, EM; Klootwijk, P; Pahlm, Olle LU ; Henden, B and Deckers, JW, et al. (2003) In American Journal of Medicine 115(8). p.613-619
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,... (More)
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. (Less)
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American Journal of Medicine
volume
115
issue
8
pages
613 - 619
external identifiers
  • pmid:14656613
  • wos:000186883800003
  • scopus:0345167961
ISSN
0002-9343
DOI
10.1016/j.amjmed.2003.08.007
language
English
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yes
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d3ff1e46-d22b-4da5-b111-9bcb2c8701d5 (old id 294005)
date added to LUP
2007-08-22 08:46:39
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2018-01-07 08:44:29
@article{d3ff1e46-d22b-4da5-b111-9bcb2c8701d5,
  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       = {Alexander, JH and Harrington, RA and Bhapkar, M and Mahaffey, KW and Lincoff, AM and Ohman, EM and Klootwijk, P and Pahlm, Olle and Henden, B and Deckers, JW and Simoons, ML and Califf, RM and Wagner, GS},
  issn         = {0002-9343},
  language     = {eng},
  number       = {8},
  pages        = {613--619},
  series       = {American Journal of Medicine},
  title        = {Prognostic importance of new small Q waves following non-ST-elevation acute coronary syndromes},
  url          = {http://dx.doi.org/10.1016/j.amjmed.2003.08.007},
  volume       = {115},
  year         = {2003},
}