Electrocardiographic correlates of reperfusion status after thrombolysis: Is the “incomplete” or “interrupted” infarction a non-Q-wave infarction?

Development and prognosis of non-Q-wave myocardial infarction in the thrombolytic era

“…'*^'^' A significant reduction in the number of Q waves and preservation of R wave amplitude was demonstrated following administration of thrombolytic therapy as compared to a placebo in two and three studies, respectively. [130][131][132] More recent studies suggest that the development of non-Q wave MI occurs in 10.4% to 43% (see Table 8, Chapter 4) in the setting of t h r~r n b o l y s i s ,~~~~~~"~~~ particularly in those patients who achieve early and sustained infarct-related artery patency. The subsequent prognosis of non-Q wave MI patients following thrombolytic therapy remains uncertain with the majority of studies not reporting on clinical utc corn es,^^^*^"'^^ some suggesting similar outcome when compared with Q wave M1,140*141*144-146 and other reports suggesting either higher reinfar~tion'~*-'" andhr m~r t a l i t y '~~ or lower rn~rtality'"*'~~ rates among the n o n 4 wave group.lu Unfortunately, evaluation of the impact of thrombolytic therapy on the rate of n o n 4 wave MI development and subsequent prognosis based on the abovementioned studies is severely limited by the lack of a placebo group in al1 but four ~tudies.~*'"~'"-~~ Limitations of these studies include small sample size, lack of standardized timing of €CG classification and Q wave definitions, and failure to report on clinical outcornes.…”

“…In view of the wide range of long terni trials follow-up, the studies in the current analysis were also stratified according to the number of rnonths of follow-up (4)(5)(6)(7)(8)(9)(10)(11)(12) months, months, and 236 months).…”

What Does the FRISC II Trial Tell Us about the Treatment of Non-Q-Wave Myocardial Infarction?

“…Thirdly, it is well established that ST elevation during infarction is not automatically followed by the development of a Q-wave MI. As many as 25-45% of patients with early ST elevation finally develop an NQMI [2,[7][8][9][10][11][12].…”