Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction |
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| Authors: | M A Hlatky R M Califf K L Lee D B Pryor G S Wagner R A Rosati |
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| Affiliation: | 1. Department of Surgery, College of Medicine, University of Oklahoma, Tulsa, Oklahoma;2. Department of Surgery, St. John Medical Center, Tulsa, Oklahoma;1. Faculty of Civil Engineering and Geosciences, Department of Water Management, Sanitary Engineering Section, Delft University of Technology (TU Delft), Stevinweg 1, 2628 CN Delft, The Netherlands;2. Faculty of Science, Department of Chemical Engineering and Food Technology, University of Cádiz, Campus Rio san Pedro, República Saharaoui s/n, 11510, Spain;3. Waternet, Korte Ouderkerkerdijk 7, P.O. Box 94370, 1090 GJ Amsterdam, The Netherlands;1. Department of Functional Sciences, Discipline of Public Health, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;2. Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School, University College London (UCL), London, UK;3. Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA;4. Department of Functional Sciences, Discipline of Pathophysiology, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania;5. School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK;6. Preventive Cardiology, CGH Medical Center, Sterling, Illinois, USA;7. The Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA;8. Center for Cardiovascular Disease Prevention, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;9. Department of Primary Care and Public Health, School of Public Health, Imperial College London, UK;10. Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands;11. Health Outcomes and Clinical Epidemiology Section, Department of Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA;12. School of Medicine, Universidad Peruana de Ciencias Aplicadas (UPC), Lima, Peru;13. Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA;14. Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA;15. Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland;p. Cardiovascular Research Centre, University of Zielona Gora, Zielona Gora, Poland;q. Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland;1. School of Medical Science & Technology, Indian Institute of Technology Kharagpur, Kharagpur 721302, West Bengal, India;2. Department of Computer Science & Engineering, Indian Institute Of Technology Kharagpur, Kharagpur 721302, West Bengal, India;3. Department of Cardiology, Medical College & Hospital, Kolkata 700073, West Bengal, India;1. University of Milan – ASST Santi Paolo e Carlo, Milan, Italy;2. City, University of London, Optometry and Visual Sciences, London, United Kingdom;3. NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom;4. G. B. Bietti Eye Foundation-IRCCS, Rome, Italy;5. University of Melbourne, Department of Optometry and Vision Sciences, Melbourne, Australia;6. University of Melbourne, School of Computing and Information System, Melbourne, Australia;7. Department of Medical and Biological Sciences, Ophthalmology Unit, University of Udine, Udine, Italy;8. Ophthalmology Unit, St. Andrea Hospital, NESMOS Department, University of Rome “Sapienza,” Rome, Italy;9. Department of Ophthalmology and Visual Sciences, University of Iowa Hospitals and Clinics, Iowa City, Iowa;10. Department of Ophthalmology, “Città di Udine” Health Center, Udine, Italy |
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| Abstract: | ![]()
To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2 and V3 had significantly larger infarctions as assessed by a QRS scoring system. Hospital mortality was 4% (3 of 75) among patients without ST depression, and 13% (11 of 87) in patients with ST depression. The relation between the amount of ST depression and hospital mortality was significant (p less than 0.001 by logistic regression), and remained significant (p less than 0.003) after adjusting for other potentially prognostic factors. Among patients discharged from the hospital, the 5-year survival was 92% in those without precordial ST depression and 80% in those with precordial ST depression (p = 0.058 by the Cox model). Precordial ST-segment depression on the admission electrocardiogram during an inferior acute myocardial infarction indicates a larger infarction, predicts a higher hospital mortality and suggests a worse long-term prognosis after discharge. |
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