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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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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
American Journal of Medicine
volume
115
issue
8
pages
613 - 619
publisher
Elsevier
external identifiers
  • pmid:14656613
  • wos:000186883800003
  • scopus:0345167961
ISSN
0002-9343
DOI
10.1016/j.amjmed.2003.08.007
language
English
LU publication?
yes
id
d3ff1e46-d22b-4da5-b111-9bcb2c8701d5 (old id 294005)
date added to LUP
2016-04-01 15:41:32
date last changed
2022-01-28 06:38:25
@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}},
  publisher    = {{Elsevier}},
  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}},
  doi          = {{10.1016/j.amjmed.2003.08.007}},
  volume       = {{115}},
  year         = {{2003}},
}