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

Publication ,  Journal Article
Birnbaum, Y; Wagner, GS; Gates, KB; Thompson, TD; Barbash, GI; Siegel, RJ; Granger, CB; Fishbein, MC; Crenshaw, BS; Califf, RM
Published in: Am J Cardiol
October 15, 2000

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.

Duke Scholars

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

October 15, 2000

Volume

86

Issue

8

Start / End Page

830 / 834

Location

United States

Related Subject Headings

  • Ventricular Septal Rupture
  • Prospective Studies
  • Myocardial Infarction
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology
 

Citation

APA
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MLA
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Birnbaum, Y., Wagner, G. S., Gates, K. B., Thompson, T. D., Barbash, G. I., Siegel, R. J., … Califf, R. M. (2000). Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction. Am J Cardiol, 86(8), 830–834. https://doi.org/10.1016/s0002-9149(00)01101-2
Birnbaum, Y., G. S. Wagner, K. B. Gates, T. D. Thompson, G. I. Barbash, R. J. Siegel, C. B. Granger, M. C. Fishbein, B. S. Crenshaw, and R. M. Califf. “Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction.Am J Cardiol 86, no. 8 (October 15, 2000): 830–34. https://doi.org/10.1016/s0002-9149(00)01101-2.
Birnbaum Y, Wagner GS, Gates KB, Thompson TD, Barbash GI, Siegel RJ, et al. Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction. Am J Cardiol. 2000 Oct 15;86(8):830–4.
Birnbaum, Y., et al. “Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction.Am J Cardiol, vol. 86, no. 8, Oct. 2000, pp. 830–34. Pubmed, doi:10.1016/s0002-9149(00)01101-2.
Birnbaum Y, Wagner GS, Gates KB, Thompson TD, Barbash GI, Siegel RJ, Granger CB, Fishbein MC, Crenshaw BS, Califf RM. Clinical and electrocardiographic variables associated with increased risk of ventricular septal defect in acute anterior myocardial infarction. Am J Cardiol. 2000 Oct 15;86(8):830–834.
Journal cover image

Published In

Am J Cardiol

DOI

ISSN

0002-9149

Publication Date

October 15, 2000

Volume

86

Issue

8

Start / End Page

830 / 834

Location

United States

Related Subject Headings

  • Ventricular Septal Rupture
  • Prospective Studies
  • Myocardial Infarction
  • Multivariate Analysis
  • Middle Aged
  • Male
  • Humans
  • Female
  • Electrocardiography
  • Cardiovascular System & Hematology