Continuous multilead ST-monitoring identifies patients with unstable coronary artery disease who benefit from extended antithrombotic treatment

European Heart Journal

Volumn 23, Issue 14, 2002, Pages 1093-1101

  Jernberg, Tomas ^a   Abrahamsson, P ^b   Lindahl, B ^a   Johanson, P ^b   Wallentin, L ^a   Dellborg, M ^b  

^a UPPSALA UNIVERSITY HOSPITAL   (Sweden)

^b SAHLGRENSKA UNIVERSITY HOSPITAL   (Sweden)

Author keywords

Electrocardiography; Low molecular weight heparin; Myocardial infarction; Prognosis; ST monitoring; Troponin T; Unstable angina

Indexed keywords

ANTICOAGULANT AGENT; DALTEPARIN; LOW MOLECULAR WEIGHT HEPARIN; TROPONIN T;

ADULT; AGED; ANTICOAGULATION; ARTICLE; CONTROLLED STUDY; CORONARY ARTERY DISEASE; DRUG EFFICACY; ELECTROCARDIOGRAPHY; FEMALE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HEART MUSCLE REVASCULARIZATION; HUMAN; MAJOR CLINICAL STUDY; MALE; OUTCOMES RESEARCH; PATIENT MONITORING; PRIORITY JOURNAL; PROGNOSIS; ST SEGMENT; UNSTABLE ANGINA PECTORIS;

ADULT; AGED; AGED, 80 AND OVER; ANGINA, UNSTABLE; CORONARY DISEASE; DALTEPARIN; DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG ADMINISTRATION SCHEDULE; ELECTROCARDIOGRAPHY; FEMALE; FIBRINOLYTIC AGENTS; FOLLOW-UP STUDIES; HUMANS; MALE; MIDDLE AGED; MONITORING, PHYSIOLOGIC; SEVERITY OF ILLNESS INDEX; SURVIVAL RATE; TIME FACTORS; TREATMENT OUTCOME;

EID: 0036629958     PISSN: 0195668X     EISSN: None     Source Type: Journal    
DOI: 10.1053/euhj.2001.3043     Document Type: Article

References (26)

1. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery disease and the acute coronary syndromes (1). N Engl J Med 1992; 326: 242-50.
2. Fuster V, Badimon L, Badimon JJ, Chesebro JH. The pathogenesis of coronary artery, disease and the acute coronary syndromes (2). N Engl J Med 1992; 326: 310-8.
3. Topol EJ, Yadav JS. Recognition of the importance of embolization in atherosclerotic vascular disease. Circulation 2000; 101: 570-80.
4. Fragmin and fast revascularisation during instability in coronary artery disease (FRISC II) investigators. Invasive compared with non-invasive treatment in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. Lancet 1999; 354: 708-15.
5. Wallentin L, Lagerqvist B, Husted S, Kontny F, Stahle E, for the FRISC II investigators. Outcome at 1 year after an invasive compared with a non-invasive strategy in unstable coronary-artery disease: The FRISC II invasive randomised trial. Lancet 2000; 356: 9-16.
6. Fragmin and fast revascularisation during instability in coronary artery disease (FRISC II) investigators. Long term low-molecular-mass heparin in unstable coronary-artery disease: FRISC II prospective randomised multicentre study. Lancet 1999; 354: 701-7.
7. Lindahl B, Venge P, Wallentin L. Troponin T identifies patients with unstable coronary artery disease who benefit from long term antithrombotic protection. J Am Coll Cardiol 1997; 29: 43-8.
8. Hamm CW, Heeschen C, Goldmann B et al. for the CAPTURE Study Investigators. Benefit of abciximab in patients with refractory unstable angina in relation to serum troponin T levels. N Engl J Med 1999; 340: 1623-9.
9. Heeschen C, Hamm CW, Goldmann B, Deu A, Langenbrink L, White HD, for the PRISM Study Investigators. Troponin concentrations for stratification of patients with acute coronary syndromes in relation to therapeutic efficacy of tirofiban. Lancet 1999; 354: 1757-62.
10. Johnson SM, Mauritson DR, Winniford MD et al. Continuous electrocardiographic monitoring in patients with unstable angina pectoris: Identification of high-risk subgroup with severe coronary disease, variant angina, and/or impaired early prognosis. Am Heart J 1982; 103: 4-12.
11. Dellborg M, Malmberg K, Rydén L, Svensson AM, Swedberg K. Dynamic on-line vectorcardiography improves and simplifies in-hospital ischemia monitoring of patients with unstable angina. J Am Coll Cardiol 1995; 26: 1501-7.
12. Klootwijk P, Meij S, v Es GA et al. Comparison of usefulness of computer assisted continuous 48-h 3-lead with 12-lead ECG ischaemia monitoring for detection and quantification of ischaemia in patients with unstable angina. Eur Heart J 1997; 18: 931-40.
13. Andersen K, Eriksson P, Dellborg M. Ischemia detected by continuous on-line vectorcardiographic monitoring predicts unfavorable outcome in patients admitted with probable unstable coronary disease. Coron Art Dis 1996; 7: 753-60.
14. Jernberg T, Lindahl B, Wallentin L. ST-segment monitoring with continuous 12-lead ECG improves early risk stratification in patients with chest pain and ECG non-diagnostic of acute myocardial infarction. J Am Coll Cardiol 1999; 34: 1413-9.
15. Klootwijk P, Meij S, Melkert R, Lenderink T, Simoons ML. Reduction of recurrent ischemia with abciximab during continuous ECG-ischemia monitoring in patients with unstable angina refractory to standard treatment (CAPTURE). Circulation 1998; 98: 1358-64.
16. Andersen K, Dellborg M, on behalf of the thrombin inhibition in myocardial ischemia (TRIM) study group. Heparin is more effective than inogatran, a low-molecular weight thrombin inhibitor in suppressing ischemia and recurrent angina in unstable coronary artery disease. Am J Cardiol 1998; 81: 939-44.
17. Goodman SG, Barr A, Sobtchouk A et al. for the Canadian ESSENCE ST segment monitoring substudy. Low molecular weight heparin decreases rebound ischemia in unstable angina or non-Q-wave myocardial infarction: The Canadian ESSENCE ST segment monitoring substudy. J Am Coll Cardiol 2000; 36: 1507-13.
18. Frank E. Accurate, clinically practical system for spatial vectorcardiography. Circulation 1956; 13: 737-44.
19. Jernberg T, Lindahl B, Wallentin L. Combination of continuous 12-lead ECG and troponin T: A valuable tool for risk stratification during the first 6 h in patients with chest pain and a non-diagnostic ECG. Eur Heart J 2000; 21: 1464-72, doi:10.1053/euhj.2000.2178.
20. Norgaard BL, Andersen K, Dellborg M, Abrahamsson P, Ravkilde J, Thygesen K. Admission risk assessment by cardiac troponin T in unstable coronary artery disease: Additional prognostic information from continuous ST segment monitoring. J Am Coll Cardiol 1999; 33: 1519-27.
21. Langer A, Freeman MR, Armstrong PW. ST segment shift in unstable angina: pathophysiology and association with coronary anatomy and hospital outcome. J Am Coll Cardiol 1989; 13: 1495-502.
22. Patel DJ, Knight CJ, Holdright DR et al. Pathophysiology of transient myocardial ischemia in acute coronary syndromes. Characterization by continuous st-segment monitoring. Circulation 1997; 95: 1185-92.
23. Biagini A, Mazzei MG, Carpeggiani C et al. Vasospastic ischemic mechanism of frequent transient ST-T changes during continuous electrocardiographic monitoring in selected unstable angina patients. Am Heart J 1982; 103: 13-20.
24. Andersen K, Dellborg M, Emanuelsson H, Grip L, Swedberg K. Thrombin inhibition with inogatran for unstable angina pectoris: Evidence for reactivated ischemia after cessation of short-term treatment. Coron Art Dis 1996; 7: 673-81.
25. Heeschen C, van den Brand MJ, Hamm CW, Simoons ML, for the CAPTURE Investigators. Angiographic findings in patients with refractory unstable angina according to troponin T status. Circulation 1999; 104: 1509-14.
26. Jernberg T, Abrahamsson P, Lindahl B, Wallentin L, Dellborg M. Comparison between continuous vectorcardiography and continuous 12-lead ECG in patients with unstable coronary artery disease. Do they identify the same population? Coron Artery Dis 2001; 12: 187-95.