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European Heart Journal Advance Access originally published online on January 26, 2005
European Heart Journal 2005 26(8):755-761; doi:10.1093/eurheartj/ehi101
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions{at}oupjournals.org

Reduced prognostic power of ventricular late potentials in post-infarction patients of the reperfusion era

Axel Bauer1,{dagger}, Przemyslaw Guzik2,{dagger}, Petra Barthel1, Raphael Schneider1, Kurt Ulm3, Mari A. Watanabe4 and Georg Schmidt1,*

1Medizinische Klinik der Technischen Universität München, Ismaninger Strasse 22, 81675 München, Germany
2Department of Cardiology, University School of Medical Sciences, Poznan, Poland
3Institut für Medizinische Statistik und Epidemiologie der Technischen Universität München, Germany
4Department of Pharmacological and Physiological Science, St Louis University School of Medicine, St Louis, MO, USA

Received 19 March 2004; revised 22 November 2004; accepted 30 November 2004; online publish-ahead-of-print 26 January 2005.

* Corresponding author. Tel: +49 8941402352; fax: +49 8941404862. E-mail address: gschmidt{at}1.tum.de

See page 747 for the editorial comment on this article (doi:10.1093/eurheartj/ehi128)

Aims To test the prognostic value of ventricular late potentials (LPs) in a large cohort of post-infarction patients in the modern reperfusion era.

Methods and results 1800 consecutive survivors of acute myocardial infarction in sinus rhythm and under 76 years of age were enrolled. Many (99%) of the patients received reperfusion/revascularization therapy (91% percutaneous coronary intervention) and up-to-date pharmacological treatment (99% aspirin, 93% beta-blockers, 90% ACE-inhibitors, and 85% statins). LPs were calculated in 968 patients and found to be present in 90 (9.3%). The primary endpoint was the composite of cardiac death and serious arrhythmic events. The secondary endpoint was the composite of sudden cardiac death and serious arrhythmic events. During follow-up (median 34 months), 26 patients reached the primary endpoint. The presence of LPs was not significantly associated with the primary endpoint in univariable or multivariable analysis. In contrast, low (≤30%) left ventricular ejection fraction (hazard ratio 9.6, 95% confidence interval 4.1–22.4), heart rate turbulence category 2 (7.5, 2.4–23.9) and category 1 (5.3, 1.9–14.9) were significant predictors in both univariable and multivariable analysis.

Conclusion Ventricular LPs are of limited use for risk stratification in unselected post-infarction patients in the modern reperfusion era.

Key Words: Ventricular late potentials • Mortality • Myocardial infarction


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