title: Bedside risk stratification after acute myocardial infarction: prospective evaluation of the use of heart rate and left ventricular function.
abstract: OBJECTIVE
  This study evaluated the predictive power of heart rate (HR) assessed from the standard 12-lead electrocardiogram (ECG) or from Holter recordings for future mortality and arrhythmic events in survivors of acute myocardial infarction (AMI).
  
  
  METHODS
  Data from 432 consecutive survivors of AMI (343 men, 89 women; mean [SD] age, 58 [11] years) were analyzed. Heart rate was assessed from a standard 12-lead ECG and from 24-hour Holter recordings obtained at hospital discharge. In addition, left ventricular ejection fraction (LVEF) was noninvasively determined. The study end point was prospectively defined as a composite end point comprising mortality and arrhythmic events (ie, sudden death, resuscitated ventricular fibrillation, sustained ventricular tachycardia). Patients were followed for an average (SD) of 41 (25) months.
  
  
  RESULTS
  Patient age, LVEF, and HR were univariate risk predictors of event-free survival. Multivariate analysis by means of a stepwise regression analysis revealed LVEF ( chi2 11.4, P = .0007), age ( chi 2 9.2, P = .02), and HR assessed from the standard 12-lead ECG ( chi2 7.1, P = .008) as independent risk parameters.
  
  
  CONCLUSIONS
  Bedside risk stratification of survivors of AMI is feasible using simple parameters such as age, LVEF, and HR.
authors.affiliation: Department of Cardiology, Division of Clinical Electrophysiology, J.W. Goethe University, D-60596 Frankfurt a. main, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Mauss
authors.forename: Thomas
authors.initials: T
authors.lastname: Klingenheben
authors.forename: Pawel
authors.initials: P
authors.lastname: Ptaszynski
authors.forename: Stefan H
authors.initials: SH
authors.lastname: Hohnloser
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000209:etiology; D018572:Disease-Free Survival; D004562:Electrocardiography; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology*; D011379:Prognosis; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*