T wave changes and postinfarction angina pectoris predictive of recurrent myocardial infarction.

The predictive value of angina pectoris and T wave changes was studied prospectively in 177 consecutive cases with acute myocardial infarction. A total of 21 reinfarctions developed within three months. In 11 of them (52%) at least one electrocardiogram recorded while in hospital showed a steeply ascending limb of the negative T wave, compared with 20 (13%) of those who did not reinfarct. Twenty-one patients had recurrent angina pectoris at rest during the hospital stay, and 10 of them (48%) developed a reinfarction within three months. When combining the electrocardiographic criteria and recurrent angina at rest, 14 of the 21 (67%) reinfarctions were correctly predicted, and 30 of the 156 (19%) patients not developing a reinfarction were falsely predicted.