Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction.


Journal Article

It is unknown whether the risk factors associated with the development of ventricular septal defect (VSD) after acute myocardial infarction (MI) remain the same when thrombolytic therapy is used, nor have specific electrocardiographic patterns of acute MI associated with the development of VSD been identified. Our study population included patients with an anterior MI enrolled in the GUSTO-I study. Baseline clinical data were collected prospectively for all patients. Patients in whom VSD was suspected by the local investigators at each site were evaluated retrospectively. Baseline clinical and electrocardiographic variables were compared between 2 groups: 10,847 patients without VSD (99.6%) and 48 patients with confirmed VSD (0.4%). Multivariate analysis showed the following clinical variables to be independent predictors of VSD: age (odds ratio [OR] 2.19, 95% confidence intervals [CI] 1.62 to 2.98; p <0.001), female gender (OR 5.07, 95% CI 2.70 to 9.98; p <0.001), and lack of previous angina (OR 2.11, 95% CI 1.12 to 4.29; p = 0.021). Two electrocardiographic variables predicted acute VSD: the magnitude of ST deviation in lead III (OR 1.55, 95% CI 1.12 to 2.21; p = 0.007) and in lead V(2) (p <0.001). However, the relation between the ST amplitude in lead V(2) and the risk for VSD was nonlinear. In patients with anterior MI who underwent thrombolysis, the risk factors for VSD were age, female gender, and lack of previous angina. Previous infarction was not a risk factor. Less ST-segment depression in lead III was a predictor of VSD.

Full Text

Duke Authors

Cited Authors

  • Birnbaum, Y; Wagner, GS; Gates, KB; Thompson, TD; Barbash, GI; Siegel, RJ; Granger, CB; Fishbein, MC; Crenshaw, BS; Califf, RM

Published Date

  • October 15, 2000

Published In

Volume / Issue

  • 86 / 8

Start / End Page

  • 830 - 834

PubMed ID

  • 11024396

Pubmed Central ID

  • 11024396

International Standard Serial Number (ISSN)

  • 0002-9149


  • eng

Conference Location

  • United States