The entry ECG in the early diagnosis and prognostic stratification of patients with suspected acute myocardial infarction.
Yusuf S., Pearson M., Sterry H., Parish S., Ramsdale D., Rossi P., Sleight P.
475 patients with suspected uncomplicated myocardial infarction (MI) were divided into 3 groups based on their entry ECG: group 1--significant ST elevation; group 2a--ST depression or T inversion; group 2b--normal ECG. Infarction was confirmed in 99.7% of group 1, 68.5% of group 2a and 39.7% of group 2b patients. Despite similar clinical, haemodynamic and historical variables at presentation, group 1 patients had significantly larger MI, more in-hospital complications and a higher short-term and long-term mortality (P less than 0.005) than group 2 patients. The entry ECG of patients with suspected MI is an excellent and simple predictor of those who are most likely to have an MI confirmed and identifies a group of patients at high risk of death or developing complications.