title: Prognosis following acute myocardial infarction in patients with ST-T abnormalities on electrocardiograms obtained before myocardial infarction.
abstract: BACKGROUND
  Many studies have examined the relationship between prognosis after myocardial infarction (MI) and electrocardiographic (ECG) findings at the time of or after the onset of MI. However, little work has been done concerning the association between ECG findings obtained before the onset of MI (pre-MI) and the prognosis after MI.
  
  
  OBJECTIVE
  The study was undertaken to determine whether ST-T segment and T-wave morphology on pre-MI ECGs provides useful information for prognosis after acute MI.
  
  
  METHODS
  Pre-MI ECGs of 212 patients recorded within the 6-month period before MI were studied for the presence of high-voltage R waves, ST-segment depression, and negative T waves. The Kaplan-Meier method and multivariate analysis were used to determine the relationship between these ECG findings and in-hospital cardiac death.
  
  
  RESULTS
  In-hospital cardiac death occurred in 32 (15.1%) patients. The in-hospital mortality rate was 38.5% (5/13) for the patients with high-voltage R waves, 54.5% (6/11) for patients with ST-segment depression, and 45.6% (15/33) for patients with negative T waves. The in-hospital mortality rate was 13.6% (27/199) for patients without high-voltage R waves, 12.9% (26/201) for patients without ST-segment depression, and 9.5% (17/179) for those without negative T waves. Multivariate analysis identified age and negative T waves as independent risk factors for cardiac death, with a hazard ratio for negative T waves of 3.1.
  
  
  CONCLUSIONS
  Negative T waves on pre-MI ECGs represent an independent predictor of in-hospital cardiac death in patients with MI.
authors.affiliation: Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Mitaka, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Ando
authors.forename: M
authors.initials: M
authors.lastname: Yotsukura
authors.forename: K
authors.initials: K
authors.lastname: Sakata
authors.forename: H
authors.initials: H
authors.lastname: Yoshino
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa
mesh_terms: D000367:Age Factors; D000368:Aged; D004562:Electrocardiography / Q000379:methods; D004594:Electrophysiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis