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European Heart Journal 1997 18(12):1903-1912;
Copyright © 1997 by the European Society of Cardiology.
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© 1997 The European Society of Cardiology

Are there differences in late outcome after PTCA for angina pectoris after non-Q wave vs Q wave myocardial infarction?

B. R. G. Brueren*, M. P. P. Rosseel{dagger}, E. T. Bal*, E. G. Mast*, J. M. P. G. Ernst*, M. J. Suttorp*, J. C. Kelder* and H. W. M. Plokker*,

*Department of Cardiology, St Antonius Hospital, Nieuwegein The Netherlands
{dagger}Department of Cardiology, Aalster Stedelijk Ziekenhuis Aalst, Belgium

Received 7 April 1997; accepted 11 April 1997.

Correspondence: H. W. M. Plokker, Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands

Abstract

AIMS: Revascularization is thought to improve prognosis better if ischaemia persists after so-called non-Q wave myocardial infarction, than after Q-wave myocardial infarction, because it is assumed that prognosis is better where there is less left ventricular function loss. This study evaluates the differences in clinical outcome between patients with Q wave and those with non-Q wave myocardial infarction who underwent percutaneous transluminal coronary angioplasty because of recurrent ischaemia.

METHODS: We retrospectively analysed two consecutive groups of patients who underwent percutaneous transluminal coronary angioplasty for ischaemia after either a non-Q wave (n=175) or a Q wave (n=175) myocardial infarction, and who were followed for 4 years.

RESULTS: Initial angioplasty success rates were similar in both groups. At follow-up there were no significant differences between the two patient groups in rates of death (9% vs 11%, P=ns), myocardial infarction (3% vs 7%, P=ns) and target vessel revascularization by repeat percutaneous angioplasty (11% vs 15%, P=ns) or coronary bypass surgery (both 7%).

CONCLUSION: We conclude that elective coronary angioplasty in patients with angina pectoris after non-Q wave myocardial infarction does not lead to a better prognosis than after Q wave myocardial infarction. Thus, management strategies after myocardial infarction should not be based on the absence or presence of Q waves on the electrocardiogram.

Key Words: Non-Q wave • myocardial infarction • percutaneous balloon angioplasty


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