The prognostic implications of negative T waves in the leads with ST segment elevation on admission in acute myocardial infarction.

We assessed the prognostic significance of negative T waves on admission in leads with ST elevation in 2,853 patients with acute myocardial infarction treated with thrombolysis. Patients were classified into 2 groups based on the presence of negative (T-) or positive (T+) T waves in the leads with ST elevation on admission. T+ and T- waves on admission were detected in 2,601 (91%) and 252 (9%) patients, respectively.

QRS complex distortion predicts no reflow after emergency angioplasty in patients with anterior wall acute myocardial infarction.

Background: In patients with acute myocardial infarction, distortion of the terminal portion of the QRS complex on the electrocardiogram (ECG) at the time of their admission to hospital is associated with larger final infarct size and greater mortality. This study assessed the results of emergency coronary angioplasty in patients with anterior acute myocardial infarction with and without distortion of the terminal portion of the QRS complex on the admission ECG.

Methods: We assessed the Thrombolysis in Myocardial Infarction (TIMI) trial flow grade, resolution of ischemic ECG changes, and clinical outcome after emergency angioplasty for acute anterior wall myocardial infarction in patients with (n = 21) and without (n = 21) distortion of the terminal portion of the QRS complex on the admission ECG.

Admission clinical and electrocardiographic characteristics predicting an increased risk for early reinfarction after thrombolytic therapy.

Background: This study assessed the ability of clinical and electrocardiographic variables routinely obtained on admission to identify patients with acute myocardial infarction treated with thrombolytic therapy at risk of early reinfarction.

Methods And Results: The study included 2602 patients who received thrombolytic therapy for acute myocardial infarction. Baseline demographic variables and admission clinical and electrocardiographic variables were compared between patients with and without reinfarction.

Admission clinical and electrocardiographic characteristics predicting in-hospital development of high-degree atrioventricular block in inferior wall acute myocardial infarction.

This study assessed the ability of simple clinical and electrocardiographic variables routinely obtained on admission to identify patients who are at high risk of developing high-degree atrioventricular (AV) block during hospitalization in 1,336 patients with inferior wall acute myocardial infarction (AMI). Patients were classified into 2 initial electrocardiographic patterns based on the J-point to R-wave amplitude ratio: pattern 1: those with J point/R wave <0.5 and pattern 2: patients with J point/R wave > or =0.

Abnormal Q waves on the admission electrocardiogram of patients with first acute myocardial infarction: prognostic implications.

Background: Q waves developed in the subacute and persisting into the chronic phase of myocardial infarction (MI) usually signify myocardial necrosis. However, the mechanism and significance of Q waves that appear very early in the course of acute MI (< 6 h from onset of symptoms), especially if accompanied by ST elevation, are probably different.

Hypothesis: This study assesses the prognostic implications of abnormal Q waves on admission in 2,370 patients with first acute MI treated with thrombolytic therapy < 6 h of onset of symptoms.