Circulation, Vol 79, 528-536, Copyright © 1989 by American Heart Association
P Nicod, E Gilpin, H Dittrich, R Polikar, A Hjalmarson, AR Blacky, H Henning and J Ross Jr
Prognosis for patients with non-Q wave myocardial infarction is
controversial although a number of studies have shown a less favorable
outlook after hospital discharge for patients with non-Q wave than for
those with Q wave infarction. Therefore, the in-hospital and 1-year
prognosis was investigated in a sufficiently large patient population (n =
2,024) to allow stratification by subgroups, in particular by age and
previous myocardial infarction. Patients with non-Q wave infarction (n =
444; 22% of the total study population) were somewhat older (65 vs. 63
years, p less than 0.001) and had an increased incidence of previous
myocardial infarction (46% vs. 24%, p less than 0.001) and congestive heart
failure (21% vs. 8%, p less than 0.001) than patients with Q wave
infarction. In-hospital mortality of patients with non-Q wave infarction
was lower (8.1% vs. 11.5%; p less than 0.06), whereas their 1-year
mortality after hospital discharge was significantly higher (13.7% vs.
9.2%, p less than 0.05) than for patients with Q wave infarction. However,
total mortalities at 1 year were nearly equal. When patients were
subgrouped by presence or absence of a previous myocardial infarction,
patients in both subgroups exhibited mortality patterns typical of the
entire population with Q wave or non-Q wave infarction. However, when
stratified by age and previous infarction, in- hospital mortality for
patients with non-Q wave infarction was significantly lower only in
patients older than 70 years of age. Similarly, the higher mortality after
hospital discharge in patients with non-Q wave infarction occurred only in
patients older than 70 years of age without previous myocardial
infarction.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Short- and long-term clinical outcome after Q wave and non-Q wave myocardial infarction in a large patient population
Division of Cardiology, University of California, San Diego Medical Center 92103-1990.
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