Skip Navigation

European Heart Journal 2001 22(21):1997-2006; doi:10.1053/euhj.2001.2750
Copyright © 2001 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow References
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (20)
Right arrowRequest Permissions
Google Scholar
Right arrow Articles by Akkerhuis, K.M.
Right arrow Articles by Simoons, M.L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Akkerhuis, K.M.
Right arrow Articles by Simoons, M.L.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

Recurrent ischaemia during continuous multilead ST-segment monitoring identifies patients with acute coronary syndromes at high risk of adverse cardiac events; meta-analysis of three studies involving 995 patients

K.M. Akkerhuisa,f1, P.A.J. Klootwijka, W. Lindeboomb, V.A.W.M. Umansc, S. Meija, P.-P. Kintb and M.L. Simoonsa

a The Thoraxcenter, University Hospital Rotterdam, The Netherlands
b Cardialysis, Clinical Research Management and Core Laboratories, Rotterdam, The Netherlands
c Division of Cardiology, Medical Center Alkmaar, The Netherlands

revised March 27, 2001; accepted April 21, 2001

Abstract

Aims Recurrent ischaemia, detected by continuous ECG monitoring, in patients with unstable angina increases the risk of unfavourable outcome. Studies that evaluated this relationship have been limited by the small series of patients. By combining data from three studies, the present analysis aims to provide an accurate assessment of the impact of recurrent ischaemia detected by multilead ECG-ischaemia monitoring on the occurrence of death and myocardial infarction in patients with acute coronary syndromes.

Methods and Results Data were obtained from CAPTURE, PURSUIT and FROST, three trials evaluating glycoprotein IIb/IIIa blockers in patients with non-ST-elevation acute coronary syndromes. Patients were monitored for 24h after enrolment with a computer-assisted 12-lead or a vectorcardiographic ECG–ischaemia monitoring device. In a retrospective blinded analysis, recurrent ischaemic episodes were identified by a computer algorithm. The number of ischaemic episodes was normalized to 24h. Ischaemic episodes were detected in 271 (27%) of 995 patients. There was a direct proportional relationship between the number of ischaemic episodes per 24h and the probability of cardiac events at 5 and 30 days. The 30-day composite of death and myocardial infarction occurred in 5·7% of patients without episodes and increased to 19·7% in patients with ≥5 episodes. After adjustment for baseline predictors of adverse outcome, the relative risk of death or myocardial infarction at 5 and 30 days increased by 25% for each additional ischaemic episode per 24h.

Conclusions This analysis emphasizes the need for integration of multilead ECG–ischaemia monitoring systems in coronary care units and emergency wards to improve early risk stratification in patients with acute coronary syndromes.

Key Words: Electrocardiography, ischaemia, acute coronary syndromes, unstable angina, ECG monitoring, prognosis

f1 Correspondence: K. Martijn Akkerhuis, MD, PhD, University Hospital Rotterdam, Room H 543, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Eur Heart JHome page
Authors/Task Force Members, J.-P. Bassand, C. W. Hamm, D. Ardissino, E. Boersma, A. Budaj, F. Fernandez-Aviles, K. A.A. Fox, D. Hasdai, E. M. Ohman, et al.
Guidelines for the diagnosis and treatment of non-ST-segment elevation acute coronary syndromes: The Task Force for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndromes of the European Society of Cardiology
Eur. Heart J., July 1, 2007; 28(13): 1598 - 1660.
[Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
R. P. Giugliano, S. D. Wiviott, P. H. Stone, D. I. Simon, M. J. Schweiger, A. Bouchard, M. A. Leesar, M. A. Goulder, S. R. Deitcher, C. H. McCabe, et al.
Recombinant Nematode Anticoagulant Protein c2 in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome: The ANTHEM-TIMI-32 Trial
J. Am. Coll. Cardiol., June 26, 2007; 49(25): 2398 - 2407.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
M. L. Simoons, I. W. G. Bobbink, J. Boland, M. Gardien, P. Klootwijk, A. W. A. Lensing, W. Ruzyllo, V. A. W. M. Umans, A. Vahanian, F. Van De Werf, et al.
A dose-finding study of fondaparinux in patients with non-ST-segment elevation acute coronary syndromes: The Pentasaccharide in Unstable Angina (PENTUA) study
J. Am. Coll. Cardiol., June 16, 2004; 43(12): 2183 - 2190.
[Abstract] [Full Text] [PDF]

Home page
 Eur Heart JHome page
M. E. Bertrand, M. L. Simoons, K. A.A. Fox, L. C. Wallentin, C. W. Hamm, E. McFadden, P. J. De Feyter, G. Specchia, and W. Ruzyllo
Management of acute coronary syndromes in patients presenting without persistent ST-segment elevation
Eur. Heart J., December 1, 2002; 23(23): 1809 - 1840.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
P.F. Cohn
The value of continuous ST segment monitoring in patients with unstable angina
Eur. Heart J., November 1, 2001; 22(21): 1972 - 1973.
[PDF]


Disclaimer:
Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.