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Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy.

Publication ,  Journal Article
Lockwood, E; Fu, Y; Wong, B; Van de Werf, F; Granger, CB; Armstrong, PW; Goodman, SG; ASSENT-2 Investigators,
Published in: Am Heart J
October 2003

BACKGROUND: Both ST resolution and Q-wave development postfibrinolysis provide important prognostic insights in patients with acute myocardial infarction (MI). However, the relative contributions of these 2 factors to risk assessment have not been examined prospectively. METHODS AND RESULTS: ST resolution and Q development were evaluated 24 to 36 hours (24-36 h) postfibrinolysis in ASSENT-2: 13,100 out of 16,949 patients who had both baseline and 24-36 h electrocardiograms free of confounders (left bundle branch block, ventricular rhythm, reinfarction before 24-36 h electrocardiograms) were included in this analysis. Q-wave MI evolved in 10,466 patients (79.9%) and 2634 patients (20.1%) had non-Q-wave MI at 24-36 h postfibrinolysis. Mortality rates at 1-year were 7.0% for patients with Q-wave MI and 5.8% for non-Q-wave MI patients, respectively (P =.046). Patients with Q-wave MI versus those without were less likely to have complete ST-segment resolution (49.1% vs 59.1%) and more likely to have partial (37.1% vs 27.8%) or no resolution (13.8% vs 13.1%) at 24 to 36 hours postfibrinolysis (P <.001). Mortality rates at 1 year for Q-wave MI with complete, partial, and no resolution were 5.2%, 8.1%, and 10.1%, respectively (P <.001), and for non-Q-wave MI with complete, partial, and no resolution were 4.5%, 7.6%, and 8.0% (P =.003). CONCLUSION: These results demonstrate the additional prognostic significance of ST-segment resolution to Q-wave development at 24 to 36 hours after fibrinolysis.

Duke Scholars

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

October 2003

Volume

146

Issue

4

Start / End Page

640 / 645

Location

United States

Related Subject Headings

  • Time Factors
  • Thrombolytic Therapy
  • Statistics as Topic
  • Prospective Studies
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Lockwood, E., Fu, Y., Wong, B., Van de Werf, F., Granger, C. B., Armstrong, P. W., … ASSENT-2 Investigators, . (2003). Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy. Am Heart J, 146(4), 640–645. https://doi.org/10.1016/S0002-8703(03)00438-1
Lockwood, Evan, Yuling Fu, Brian Wong, Frans Van de Werf, Christopher B. Granger, Paul W. Armstrong, Shaun G. Goodman, and Shaun G. ASSENT-2 Investigators. “Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy.Am Heart J 146, no. 4 (October 2003): 640–45. https://doi.org/10.1016/S0002-8703(03)00438-1.
Lockwood E, Fu Y, Wong B, Van de Werf F, Granger CB, Armstrong PW, et al. Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy. Am Heart J. 2003 Oct;146(4):640–5.
Lockwood, Evan, et al. “Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy.Am Heart J, vol. 146, no. 4, Oct. 2003, pp. 640–45. Pubmed, doi:10.1016/S0002-8703(03)00438-1.
Lockwood E, Fu Y, Wong B, Van de Werf F, Granger CB, Armstrong PW, Goodman SG, ASSENT-2 Investigators. Does 24-hour ST-segment resolution postfibrinolysis add prognostic value to a Q wave? An ASSENT 2 electrocardiographic substudy. Am Heart J. 2003 Oct;146(4):640–645.
Journal cover image

Published In

Am Heart J

DOI

EISSN

1097-6744

Publication Date

October 2003

Volume

146

Issue

4

Start / End Page

640 / 645

Location

United States

Related Subject Headings

  • Time Factors
  • Thrombolytic Therapy
  • Statistics as Topic
  • Prospective Studies
  • Prognosis
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Humans
  • Female