Prognostic value of standard electrocardiographic parameters for predicting major adverse cardiac events after acute myocardial infarction.
BACKGROUND
The prognostic value of electrocardiographic (ECG) variables in predicting major adverse cardiac events (MACEs) after acute myocardial infarction (AMI) in the era of modern therapy is unclear. This study was conducted to evaluate the prognostic significance of ECG parameters in predicting 1-year MACEs for AMI patients.


METHODS
Between January 2006 and January 2008, 529 AMI patients were included. ECG variables were analyzed from the ECG taken on discharge day. The 1-year MACEs were defined as death, nonfatal 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%) patients provided complete follow-up data (355 males; 67 ± 12 years old). The rate of 1-year MACEs was 16%. In univariate analysis, heart rate, corrected QT interval, left ventricular (LV) hypertrophy, voltage (SV(1) + RV(5) ), lateral ST-depression (V(5-6) or I, aVL), pathologic Q wave (V(1-4) , V(5-6) ), ST-elevation (V(1-4) , V(5-6) or I, aVL), and T-wave inversion (V(1-4) , V(5-6) , 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 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.


CONCLUSIONS
Lateral ST-depression on discharge day ECG is an independent predictor of 1-year MACEs after AMI.
Department of Internal Medicine, Kyungpook National University Hospital, 200 Dongduk-ro, Jung-gu, Daegu, Republic of Korea.
Won Suk
WS
Choi
Jang Hoon
JH
Lee
Sun Hee
SH
Park
Kyun Hee
KH
Kim
Jung Kyu
JK
Kang
Na Young
NY
Kim
Hyun Jun
HJ
Cho
Jae Yong
JY
Yoon
Sang Hyuk
SH
Lee
Myung Hwan
MH
Bae
Hyeon Min
HM
Ryu
Dong Heon
DH
Yang
Hun Sik
HS
Park
Yongkeun
Y
Cho
Shung Chull
SC
Chae
Jae-Eun
JE
Jun
Wee-Hyun
WH
Park
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D004562:Electrocardiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D009203:Myocardial Infarction / Q000150:complications* / Q000401:mortality; D011379:Prognosis; D012086:Reoperation
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