INTRODUCTION/ METHODS: To assess whether revised electrocardiographic (ECG) criteria improve emergency department identification of patients with acute myocardial infarction (MI) or unstable angina (UA) and predict outcome, we studied 120 patients with a nondiagnostic initial ECG by prior criteria. Electrocardiograms were read in a blinded fashion months apart with standard and then revised criteria, and analyzed by χ(2) and logistic regression analysis. RESULTS: In 12 subjects (10%), the initial ECG was now interpreted as diagnostic of ischemia. Eleven (92%) had an MI, 1 had UA (8%), and none had a noncardiac diagnosis. Ischemic ECG changes were strongly associated with MI or UA (P = .003). At 1-year follow-up, ECG changes diagnostic of ischemia were associated with a trend toward higher mortality (25% vs 7%, P = .07), but after adjustment for clinical factors, ECG changes were not an independent predictor of 1-year mortality. CONCLUSIONS: Revision of the ECG criteria for ischemia was associated with enhanced diagnostic performance and identified a subset of patients at higher risk.
INTRODUCTION/ METHODS: To assess whether revised electrocardiographic (ECG) criteria improve emergency department identification of patients with acute myocardial infarction (MI) or unstable angina (UA) and predict outcome, we studied 120 patients with a nondiagnostic initial ECG by prior criteria. Electrocardiograms were read in a blinded fashion months apart with standard and then revised criteria, and analyzed by χ(2) and logistic regression analysis. RESULTS: In 12 subjects (10%), the initial ECG was now interpreted as diagnostic of ischemia. Eleven (92%) had an MI, 1 had UA (8%), and none had a noncardiac diagnosis. IschemicECG changes were strongly associated with MI or UA (P = .003). At 1-year follow-up, ECG changes diagnostic of ischemia were associated with a trend toward higher mortality (25% vs 7%, P = .07), but after adjustment for clinical factors, ECG changes were not an independent predictor of 1-year mortality. CONCLUSIONS: Revision of the ECG criteria for ischemia was associated with enhanced diagnostic performance and identified a subset of patients at higher risk.
Authors: Peter W Macfarlane; David Browne; Brian Devine; Elaine Clark; Evan Miller; Jodat Seyal; David Hampton Journal: J Electrocardiol Date: 2004 Impact factor: 1.438
Authors: Barbara J Drew; Daniel M Schindler; Jessica K Zegre; Kirsten E Fleischmann; Robert L Lux Journal: J Electrocardiol Date: 2007 Nov-Dec Impact factor: 1.438
Authors: Vladimir Shusterman; Anna Goldberg; Daniel M Schindler; Kirsten E Fleischmann; Robert L Lux; Barbara J Drew Journal: J Electrocardiol Date: 2007 Nov-Dec Impact factor: 1.438
Authors: Y Birnbaum; I Herz; S Sclarovsky; B Zlotikamien; A Chetrit; L Olmer; G I Barbash Journal: J Am Coll Cardiol Date: 1996-04 Impact factor: 24.094