The relationship between T-wave polarity and clinical as well as angiographic findings in the early stage of acute myocardial infarction.

Background: Restoration of a positive T-wave in the chronic stage of myocardial infarction (MI) is usually seen in patients with a non-Q-wave (non-transmural) MI, where a viable tissue is present. The causes and significance of a positive T-wave in the early phase of acute MI are not clear.

Aim: To investigate angiographic and clinical characteristics of patients with a positive T-wave in the early stage of acute MI.

Methods: We evaluated the clinical and angiographic data in relation to T-wave polarity in 188 patients with acute MI. Coronary risk factors, pre-infarction angina, CK-MB level, left ventricular ejection fraction and angiographic findings were analysed. Death, cardiogenic shock, ventricular tachycardia/fibrillation and high-degree atrioventricular block were regarded as in-hospital complications. All electrocardiograms were divided into two groups, according to the shape of the T-wave, as exhibiting a positive T-wave or negative T-wave.

Results: A positive T-wave was present in 30 (15.9%) patients. None of the patients with a positive T-wave had three-vessel disease compared with 21.5% of patients with a negative T-wave (p <0.04). In-hospital complication rates were similar in both groups.

Conclusions: Patients with a positive T-wave in the early phase of acute MI have significantly less frequently three-vessel disease than patients with a negative T-wave.