Prognostic significance of precordial ST-segment changes in acute inferior wall myocardial infarction.
OBJECTIVE
To examine the clinical significance of precordial ST-segment changes in patients with acute Q-wave inferior wall myocardial infarction.


METHODS
Prospective evaluation (clinical follow-up) of Q-wave inferior wall myocardial infarction over a 6-year period in patients who fulfilled the inclusion criteria.


METHODS
Coronary care unit at a university hospital.


METHODS
Two hundred consecutive patients with acute Q-wave inferior wall myocardial infarction admitted to the coronary care unit within 24 h from the onset of chest pain.


RESULTS
Precordial ST-segment depression resolved <24 h (transient) after admission in 84 patients, lasted > or = 24 h (persistent) in 48 patients, and was absent in 68 patients, while ST-segment elevation in V4R was detected in 60 patients. Seventy-one patients had major in-hospital complications and 18 patients died in the hospital. When nine variables were used in the multivariate analysis, right ventricular dilatation and persistent precordial ST-segment depression were the important factors related to major in-hospital complications, whereas age, alveolar arterial oxygen difference, and persistent precordial ST-segment depression were important for in-hospital deaths.


CONCLUSIONS
Left ventricular posterior wall involvement, diagnosed by persistent precordial ST-depression, was an independent and stronger predictor of major in-hospital complications and deaths than right ventricular involvement in patients with acute Q-wave inferior wall myocardial infarction.
Sugiura
T
T
The Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Nagahama
Y
Y
Takehana
K
K
Takahashi
N
N
Iwasaka
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003325:Coronary Care Units; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality*; D011379:Prognosis; D011446:Prospective Studies