Extent of ST-segment depression and cardiac events in non-ST-segment elevation acute coronary syndromes

European Heart Journal

Volumn 26, Issue 20, 2005, Pages 2106-2113

  Savonitto, Stefano ^a   Cohen, Mauricio G ^b   Politi, Alessandro ^c   Hudson, Michael P ^d,e   Kong, David F ^d,e   Huang, Yao ^e   Pieper, Karen S ^e   Mauri, Francesco ^a   Wagner, Galen S ^d,e   Califf, Robert M ^d,e   Topol, Eric J ^f   Granger, Christopher B ^d,e  

^a AO Niguarda Ca' Granda   (Italy)

^b UNIVERSITY OF NORTH CAROLINA SCHOOL OF MEDICINE   (United States)

^c SANT ANNA HOSPITAL   (Italy)

^d DUKE UNIVERSITY MEDICAL CENTER   (United States)

^e DUKE CLINICAL RESEARCH INSTITUTE   (United States)

^f LERNER RESEARCH INSTITUTE   (United States)

Author keywords

Electrocardiogram; Logistic regression analysis; Myocardial infarction; Non ST segment elevation acute coronary syndromes; Prognosis

Indexed keywords

ACETYLSALICYLIC ACID; BETA ADRENERGIC RECEPTOR BLOCKING AGENT; CALCIUM CHANNEL BLOCKING AGENT; CREATINE KINASE; FIBRINOLYTIC AGENT; HEPARIN; NITRATE;

ADULT; AGED; ARTICLE; BLOOD CLOT LYSIS; CAUSE OF DEATH; CLINICAL TRIAL; CONTROLLED CLINICAL TRIAL; CONTROLLED STUDY; CORONARY ARTERY DISEASE; CORRELATION ANALYSIS; FEMALE; HEART INFARCTION; HEART MUSCLE ISCHEMIA; HEART REINFARCTION; HOSPITAL ADMISSION; HUMAN; LEFT CORONARY ARTERY; MAJOR CLINICAL STUDY; MALE; MULTIVARIATE LOGISTIC REGRESSION ANALYSIS; PATIENT SELECTION; PREDICTION; PREVALENCE; PRIORITY JOURNAL; ST SEGMENT DEPRESSION; ST SEGMENT ELEVATION; T WAVE; TREATMENT INDICATION;

ACUTE DISEASE; AGED; ANALYSIS OF VARIANCE; ELECTROCARDIOGRAPHY; HOSPITALIZATION; HUMANS; MALE; MIDDLE AGED; MYOCARDIAL ISCHEMIA; PROGNOSIS; REGRESSION ANALYSIS; RISK ASSESSMENT; RISK FACTORS; SYNDROME;

EID: 26044462168     PISSN: 0195668X     EISSN: 15229645     Source Type: Journal    
DOI: 10.1093/eurheartj/ehi395     Document Type: Article

References (39)

1. Cannon CP. Optimizing the treatment of unstable angina. J Thromb Thrombolysis 1995;2:205-218.
2. Fox KA, Goodman SG, Klein W, Brieger D, Steg PG, Dabbous O, Avezum A, for the GRACE Investigators. Management of acute coronary syndromes. Variations in practice and outcomes; findings from the Global Registry of Acute Coronary Events (GRACE). Eur Heart J 2002;23:1177-1189.
3. Armstrong PW, Fu Y, Chang WC, Topol EJ, Granger CB, Betriu A, Van de Werf F, Lee KL, Califf RM. Acute coronary syndromes in the GUSTO-IIb trial: prognostic insights and impact of recurrent ischemia. Circulation 1998;98:1860-1868.
4. Zaacks SM, Liebson PR, Calvin JE, Parrillo JE, Klein LW. Unstable angina and non-Q wave myocardial infarction: does the clinical diagnosis have therapeutic implications? J Am Coll Cardiol 1999;33:107-118.
5. Bertrand ME, Simoons ML, Fox KA, Wallentin LC, Hamm CW, McFadden E, De Feyter PJ, Specchia G, Ruzyllo W; Task Force on the Management of Acute Coronary Syndromes of the European Society of Cardiology. Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J 2002;23:1809-1840.
6. Braunwald E, Antman EM, Beasley JW, Califf RM, Cheitlin MF, Hochman JS, Jones RH, Kereiakes D, Kupersmith J, Levin TN, Pepine CJ, Schaeffer JW, Smith EE III, Steward DE, Theroux O. ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-segment elevation myocardial infarction. http://www.acc.org/clinical/guidelines/unstable/unstable.pdf (22 June 2004).
7. Antman EM, Cohen M, Bernink PJ, McCabe CH, Horacek T, Papuchis G, Mautner B, Corbalan R, Radley D, Braunwald E. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 2000;284:835-842.
8. Roberts R, Fromm RE. Management of acute coronary syndromes based on risk stratification by biochemical markers: an idea whose time has come. Circulation 1998;98:1831-1833.
9. Nyman I, Areskog M, Areskog NH, Swahn W, Wallentin L, for the RISC Study Group. Very early risk stratification by electrocardiogram at rest in men with suspected unstable coronary heart disease. J Intern Med 1993;234:293-301.
10. Cannon CP, McCabe CH, Stone PH, Rogers WJ, Schactman M, Thompson BW, Pearce DJ, Diver DJ, Kells K, Feldman T, Williams M, Gibson RS, Kronenberg MW, Ganz LI, Anderson HV, Braunwald E, for the TIMI III Registry ECG Ancillary Study Investigators. The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q-wave myocardial infarction: results of the TIMI III Registry ECG Ancillary Study. J Am Coll Cardiol 1997;30:133-140.
11. Savonitto S, Ardissino D, Granger CB, Morando G, Mafrici A, Lee KL, Vahanian A, Ohman EM, Califf R, Van de Werf, Topol EJ. Prognostic value of the admission electrocardiogram in acute coronary syndromes. JAMA 1999;281:707-713.
12. Krone RJ, Greenberg H, Dwyer EM, Klieger RE, Boden WE and the Multicenter Diltiazem Postinfarction Trial Research Group. Long-term prognostic significance of ST-segment depression during acute myocardial infarction. J Am Coll Cardiol 1993;22:361-367.
13. The GUSTO-IIb Investigators. A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes. N Engl J Med 1996;335:775-782.
14. Kaul P, Fu Y, Chang W, Harrington RA, Wagner GS, Goodman SG, Granger CB, Moliterno DJ, Van de Werf F, Califf RM, Topol EJ, Armstrong PW for the GUSTO-IIB and PARAGON-A Investigators. Prognostic value of ST segment depression in acute coronary syndromes: insights from PARAGON-A applied to GUSTO-IIB. J Am Coll Cardiol 2001;38:64-71.
15. Harrell FE Jr. Regression Modeling Strategies. Springer Series in Statistics. 2001. Vol. 119. Springer; p94-96.
16. Hamm CW, Braunwald EA. A classification of unstable angina revisited. Circulation 2000;102:118-122.
17. FTT Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet 1994;343:311-322.
18. Hathaway WR, Peterson ED, Wagner GS, Granger CB, Zabel KM, Pieper KS, Clark KA, Woodlief LH, Califf RM. Prognostic significance of the initial electrocardiogram in patients with acute myocardial infarction. JAMA 1998;279:387-391.
19. Hyde TA, French JK, Wong CK, Straznicky IT, Whitlock RM, White HD. Four-year survival of patients with acute coronary syndromes without ST-segment elevation and prognostic significance of 0.5 mm ST-segment depression. Am J Cardiol 1999;84:379-385.
20. Diderholm E, Andren B, Frostfeldt G, Genberg M, Jernberg T, Lagerqvist B, Lindhal B, Wallentin L and the FRISC Investigators. ST depression in ECG at entry indicates severe coronary lesions and large benefits of an early invasive treatment strategy in unstable coronary artery disease. The FRISC II ECG substudy. Eur Heart J 2002;23:41-49.
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;13:1495-1502.
22. Sclarovsky S, Rechavia E, Strasberg B, Sagie A, Bassevich R, Kusniec J, Mager A, Agmon J. Unstable angina: ST segment depression with positive versus negative T wave deflections-clinical course, ECG evolution, and angiographic correlation. Am Heart J 1988;116:933-941.
23. Sclarovsky S. Acute circumferential ischemia evolving to acute myocardial infarction. In: Sclarovsky S, ed. Electrocardiography of Acute Myocardiai Ischemic Syndromes. London: Martin Dunitz Ltd; 1999. p88-98.
24. Palacios I, Johnson RA, Newell JB, Powell WJ Jr. Left ventricular end-diastolic pressure volume relationships with experimental acute global ischemia. Circulation 1976;53:428-436.
25. Visner MS, Aventzen CE, Parrish DG, Larson EV, O'Connor MJ, Crumbley AJ III, Bache RJ, Anderson RW. Effect of global ischemia on the diastolic properties of the left ventricle in conscious dogs. Circulation 1985;71:610-619.
26. de Zwaan C, Baer FW, Janssen JHA, Cheriex EC, Dassen WR, Brugada P, Penn OC, Wellens HJ. Angiographic and clinical characteristics of patients with unstable angina showing an ECG pattern indicating critical narrowing of the proximal LAD coronary artery. Am Heart J 1989;117:657-665.
27. Pahlm-Webb U, Pahlm O, Sadanandan S, Selvester RH, Wagner GS. A new method for using direction of ST-segment deviation to localize the site of acute coronary occlusion: the 24-view standard electrocardiogram. Am J Med 2002;113:75-78.
28. Mauri F, Gasparini M, Barbonaglia L, Santoro E, Franzosi MG, Tognoni G, Rovelli F. Prognostic significance of the extent of myocardial injury in acute myocardial infarction treated by streptokinase (the GISSI trial). Am J Cardiol 1989;63:1291-1295.
29. Mauri F, Franzosi MG, Maggioni AP, Santoro E, Santoro L. Clinical value of 12-lead electrocardiography to predict long-term prognosis of GISSI-1 patients. J Am Coll Cardiol 2002;39:1594-1600.
30. Yusuf S, Lopez R, Maddison A, Maw P, Ray N, McMillan S, Sleight P. Value of the electrocardiogram in predicting and estimating infarct size in man. Br Heart J 1979;42:286-293.
31. Wagner GS, Freye CJ, Palmeri ST, Roark SF, Stack NC, Ideker RE, Harrell FE Jr, Selvester RH. Evaluation of a QRS scoring system for estimating infarct size. I. Specificity and observer agreement. Circulation 1982;65:342-347.
32. Aldrich HR, Wagner NB, Boswick J, Corsa AT, Jones MG, Grande P, Lee KL, Wagner GS. Use of initial ST-segment deviation for prediction of final electrocardiographic size of acute myocardial infarcts. Am J Cardiol 1988;61:749-753.
33. Juergens CP, Fernandes C, Hasche ET, Meikle S, Bautovich G, Currie CA, Freedman SB, Leremy RW. Electrocardiographic measurement of infarct size after thrombolytic therapy. J Am Coll Cardiol 1996;27:617-624.
34. Detrano R, Gianrossi R, Mulvihill D, Lehmann K, Dubach P, Colombo A, Froelicher V. Exercise-induced ST segment depression in the diagnosis of multivessel coronary artery disease: a meta-analysis. J Am Coll Cardiol 1989;14:1501-1508.
35. Gorgels AP, Vos MA, Mulleneers R, de Zwaan C, Bar FW, Wellens H. Value of the electrocardiogram in diagnosing the number of severely narrowed coronary arteries in rest angina pectoris. Am J Cardiol 1993;72:999-1003.
36. Go AS, Barron HV, Rundle AC, Ornato JP, Avins AL. Bundle-branch block and in-hospital mortality in acute myocardial infarction. National Registry of Myocardial Infarction 2 Investigators. Ann Intern Med 1998;129:690-697.
37. Savonitto S, Granger CB, Ardissino D, Gardner L, Cavallini C, Galvani M, Ottani F, White HD, Armstrong PW, Pieper KS, Ohman EM, Califf RM, Topol EJ, for the GUSTO-IIb Investigators. The prognostic value of creatine kinase elevations extends across the whole spectrum of the acute coronary syndromes. J Am Coll Cardiol 2002;39:22-29.
38. Ohman EM, Armstrong PW, Christenson RH, Granger CB, Katus HA, Hamm CW, O'Hanesian M, Wagner GS, Kleiman NS, Harrell FE, Califf RM, Topol EJ, Lee KL, for the GUSTO-IIa Investigators. Cardiac troponin T levels for risk stratification in acute myocardial ischemia. N Engl J Med 1996;335:1333-1341.
39. Antman EM, Tanasijevic MJ, Thompson B, Scactman M, McCabe CH, Cannon CP, Fischer GA, Fung AY, Thompson C, Wybenga D, Braunwald E. Cardiac-specific troponin I levels to predict risk of mortality in patients with acute coronary syndromes. N Engl J Med 1996;335:1342-1349.