Prognostic Value of Standard Electrocardiographic Parameters for Predicting Major Adverse Cardiac Events after Acute Myocardial Infarction

Choi, Won Suk; Lee, Jang Hoon; Kim, Kyun Hee; Kang, Jung Kyu; Kim, Na Young; Cho, Hyun Jun; Yoon, Jae Yong; Lee, Sang Hyuk; Bae, Myung Hwan; Ryu, Hyun-Mee; Yang, Dong Heon; Park, Hun Sik; Cho, Yongkeun; Chae, Shung Chull; Jun, Jae Bok; Park, Wee-Hyun

doi:10.1111/j.1542-474x.2010.00409.x

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…It is thus a major focus in basic understanding of myocardial infarction and clinical monitoring of patients with ischemic myocardium [24]. In the present study, we have observed the development of QT (or QTc) prolongation 1 month after the LAD ligation and its persistence until the end of the 6 months experiment.…”

Section: Discussionmentioning

confidence: 83%

Electrocardiographic Characterization of Rhesus Monkey Model of Ischemic Myocardial Infarction Induced by Left Anterior Descending Artery Ligation

et al. 2011

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Myocardial infarction is a leading cause for morbidity and mortality in the modern society. Rhesus monkeys are excellent animal models for experimental and translational studies of cardiovascular diseases in humans. However, some detailed characterizations of cardiovascular disease, such as myocardial infarction, in Rhesus monkeys have not been available. The present study was undertaken to examine the progressive electrocardiographic changes in Rhesus monkeys after left anterior descending (LAD) artery ligation. Male Rhesus monkeys, aged 2-3 years and weighed 4.5-6.0 kg, were subjected to LAD ligation along with sham-operated controls. At 1 week, 1 month, and 6 months after the LAD ligation, ECG recording was performed to detect the progressive changes in ECG. In addition, cardiac magnetic resonance imaging (MRI) and echocardiography were applied to detect the myocardial infarction induced by LAD ligation, and histopathological examination was performed at the end of the experiment to measure the morphological changes. The results showed that QRS and ST-T changed significantly within 1 month after LAD ligation, but recovered to normal at the end of the experiment. The most significant change was a progressive QTc prolongation, which occurred corresponding to the development of myocardial infarction. Both cardiac MRI and echocardiography detected the myocardial infarction that was confirmed by the histopathological examination. This detailed characterization of ECG changes along with the development of myocardial infarction induced by LAD ligation thus demonstrated that the Rhesus monkey model of ischemic myocardial infarction would be an excellent surrogate for human myocardial infarction. This model would also provide an excellent tool for drug discovery and development for cardiac disease.

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Section: Discussionmentioning

confidence: 83%

Electrocardiographic Characterization of Rhesus Monkey Model of Ischemic Myocardial Infarction Induced by Left Anterior Descending Artery Ligation

et al. 2011

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“…The majority of information comes from studies that measured the QT interval manually from a single lead with 10 second ECG during rest (3, 6–8). Recent techniques are automatic and capable of measuring the QT interval continuously using a root mean square signal that gathers ECG information from the 12 ECG leads simultaneously (9).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and prognostic significance of long QT interval among patients with chest pain: selecting an optimum QT rate correction formula

Hasanien¹,

Drew²,

Howie-Esquivel³

et al. 2013

Journal of Electrocardiology

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Background Little is known about the prevalence and prognostic significance of long QT interval among patients with chest pain during the acute phase of suspected cardiovascular injury. Objectives Our aim was to investigate the prevalence and prognostic significance of long QT interval among patients presenting to the emergency department (ED) with chest pain using an optimum QT rate correction formula. Methods We performed secondary analysis on data obtained from the IMMEDIATE AIM trial (N, 145). Data included 24-hour 12-lead Holter electrocardiographic recordings that were stored for offline computer analysis. The QT interval was measured automatically and rate corrected using seven QTc formulas including subject specific correction. The formula with the closer to zero absolute mean QTc/RR correlation was considered the most accurate. Results Linear and logarithmic subject specific QT rate correction outperformed other QTc formulas and resulted in the closest to zero absolute mean QTc/RR correlations (mean ± SD; 0.003 ± 0.002; 0.017 ± 0.016; respectively). These two formulas produced adequate correction in 100% of study participants. Other formulas (Bazett’s, Fridericia’s, Framingham, and Study specific) resulted in inadequate correction in 47.6 to 95.2% of study participants. Using the optimum QTc formula, linear subject specific, the prevalence of long QTc interval was 14.5%. The QTc interval did not predict mortality or hospital admission at short and long term follow-up. Only the QT/RR slope predicted mortality at 7 year follow-up (odds ratio, 2.01; 95% CI, 1.02 to 3.96; p < 0.05). Conclusions Adequate QT rate correction can only be performed using subject specific correction. Long QT interval is not uncommon among patients presenting to the ED with chest pain.

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“…Some sources have shown that prolonged corrected QT intervals are predictive of cardiac events after MI [ 36 ]. Elsewhere, however, pathologic Q waves, corrected QT intervals, and previous ischemic heart disease were unrelated to prognosis (i.e., major adverse cardiac events) [ 37 ]. Still, one publication does maintain that fQRS complexes are superior to pathologic Q waves in terms of their sensitivity to and negative predictive value for myocardial scarring [ 38 ].…”

Section: Discussionmentioning

confidence: 99%

Fragmented QRS and abnormal creatine kinase-MB are predictors of coronary artery disease in patients with angina and normal electrocardiographys

Lee

Jeong

et al. 2017

Korean J Intern Med

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Background/AimsPatients with symptoms of coronary artery disease (CAD) often display normal tracings or only nonspecific changes on electrocardiography (ECG). The aim of this study was to explore strategic elements of the ECG and other potential factors that are predictive of CAD in this scenario.MethodsThis was an observational study of 142 patients with the chief complaint of chest pain, each of whom presented with a normal ECG and was subjected to emergency coronary angiography (CAG). Two population subsets were identified: those patients (n = 97) with no significant stenotic lesions and those (n = 45) with the significant stenotic lesions of CAD.ResultsThose patients with normal or nonspecific ECGs and CAD (15.8%) were more likely to have left circumflex artery involvement (20% vs. 7%). In patients with normal ECGs and CAD (vs. normal CAG), male sex (86.7% vs. 68%, p = 0.023), creatine kinase-MB (CK-MB) levels > 10 U/L (13 vs. 10, p = 0.025), and fragmented QRS (fQRS) (38.6% vs. 21.6%, p = 0.042) occurred with greater frequency. In multivariable analysis, the following variables were significant predictors of CAD, given a normal ECG: male sex (odds ratio [OR], 2.593; 95% confidence interval [CI], 1.068 to 5.839); CK-MB (OR, 2.497; 95% CI, 0.955 to 7.039); and W- or M-shaped QRS complex (OR, 2.306; 95% CI 0.988 to 5.382).ConclusionsIn our view, male sex, elevated CK-MB (> 10 U/L), and fQRS complexes are suspects for CAD in patients with angina and unremarkable ECGs and should be considered screening tests.

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Prognostic Value of Standard Electrocardiographic Parameters for Predicting Major Adverse Cardiac Events after Acute Myocardial Infarction

Abstract: Lateral ST-depression on discharge day ECG is an independent predictor of 1-year MACEs after AMI.

Cited by 10 publications

References 26 publications

Electrocardiographic Characterization of Rhesus Monkey Model of Ischemic Myocardial Infarction Induced by Left Anterior Descending Artery Ligation

Electrocardiographic Characterization of Rhesus Monkey Model of Ischemic Myocardial Infarction Induced by Left Anterior Descending Artery Ligation

Prevalence and prognostic significance of long QT interval among patients with chest pain: selecting an optimum QT rate correction formula

Fragmented QRS and abnormal creatine kinase-MB are predictors of coronary artery disease in patients with angina and normal electrocardiographys

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