Abstract 9026: Prognostic Value of Standard Electrocardiographic Parameters for Predicting Major Adverse Cardiac Events After Acute Myocardial Infarction
Background: Data on the prognostic value of electrocardiographic (ECG) variables in predicting major adverse cardiac events (MACE) after acute myocardial infarction (AMI) in the era of modern therapy are limited. This study was conducted to evaluate the prognostic significance of different ECG parameters in predicting 1-year MACEs for patients with AMI.
Methods: Between January 2006 and January 2008, 529 AMI patients underwent standard ECG recording on discharge day. ECG variables including time intervals and PQRST abnormalities were analyzed from the ECG. The 1-year MACEs were defined as death, non-fatal MI, and revascularization including repeat percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Mean follow-up duration was 360±119 days.
Results: Of these patients, 497 (94.0%) patients provided complete follow-up data (355 males; 67±12 years old). The rate of 1-year MACEs was 16.3%. In univariate analysis, heart rate, corrected QT interval, left ventricular hypertrophy, voltage (SV1 + RV5), lateral ST-depression (V5–6 or I, aVL), pathologic Q wave (V1–4, V5–6), ST-elevation (V1–4, V5–6 or I, aVL), and T-wave inversion (V1–4, V5–6, or I, aVL) had a significant association with 1-year MACEs. In the Cox regression hazard model, lateral ST-depression (hazard ratio [HR] 2.260, 95% confidence interval [CI] 1.204 to 4.241, p=0.011) and corrected QT interval (HR 1.007, 95% CI 1.002 to 1.011, p=0.004) were independent ECG predictors of 1-year MACEs. After adjustment for all risk variables, lateral ST-depression (HR 3.781, 95% CI 1.047 to 13.656, p=0.042) was the only ECG variable that independently predicted 1-year MACEs.
Conclusion: Lateral ST-depression on the ECG from AMI patients taken from AMI patients on discharge day is an independent predictor of 1-year MACEs after AMI.
- © 2010 by American Heart Association, Inc.