The entry ECG in the early diagnosis and prognostic stratification of patients with suspected acute myocardial infarction

475 patients with suspected uncomplicated myocardial infarction(MI) were divided into 3 groups based on their entry ECG: group1 — significant ST elevation; group 2a — ST depressionor T inversion, group 2b — normal ECG. Infarction wasconfirmed in 99.7% of group 1, 68.5% of group 2a and 39.7% ofgroup 2b patients. Despite similar clinical, haemodynamic andhistorical variables at presentation, group 1 patients had significantlylarger MI, more in-hospital complications and a higher short-termand longterm mortality (P<0.005) than group 2 patients. The entry ECG of patients with suspected MI is an excellentand simple predictor of those who are most likely to have anMI confirmed and identifies a group of patients at high riskof death or developing complications.