title: The prognostic significance of intermediate QRS prolongation in acute myocardial infarction.
abstract: Complete right and left bundle branch block and advanced atrioventricular block present on admission electrocardiograms of patients with acute myocardial infarction, are associated with poor short and long-term outcome. Little is known about the impact of intermediate QRS prolongation (0.09-0.11 s) on the prognosis of acute myocardial infarction. In this study, among 1100 consecutive patients with acute myocardial infarction treated with thrombolysis, the QRS duration on admission electrocardiogram was <0.09 s in 536 (48%) patients, between 0.09 and 0.11 s in 496 (45%) patients and >0.11 s in 78 (7%) patients. QRS duration was strongly associated with 7-day (0.6%, 6%,18%, P<0.001), 30-day (1%, 8%, 22%, P<0.001) and 1-year (3%, 11%, 26%, P<0.001) all-cause mortality. After adjustment for significant variables associated with 1-year mortality, including age, female gender, diabetes mellitus, systemic hypertension, previous myocardial infarction, anterior myocardial infarction and Killip class> or =2 on admission, both levels of QRS prolongation remained significant independent predictors of short and long-term all-cause mortality.
authors.affiliation: Charles University, Hradec Kralove, Czech Republic.
authors.forename: R
authors.initials: R
authors.lastname: Pudil
authors.forename: M S
authors.initials: MS
authors.lastname: Feinberg
authors.forename: H
authors.initials: H
authors.lastname: Hod
authors.forename: V
authors.initials: V
authors.lastname: Boyko
authors.forename: L
authors.initials: L
authors.lastname: Mandelzweig
authors.forename: S
authors.initials: S
authors.lastname: Behar
mesh_terms: D000704:Analysis of Variance; D001145:Arrhythmias, Cardiac / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D018153:Czech Republic / Q000453:epidemiology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D011237:Predictive Value of Tests; D011379:Prognosis; D012306:Risk; D016019:Survival Analysis; D015912:Thrombolytic Therapy