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European Heart Journal 2001 22(12):1008-1014; doi:10.1053/euhj.2000.2426
Copyright © 2001 by the European Society of Cardiology.
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Does the electrocardiographic presence of Q waves influence the survival of patients with acute myocardial infarction?

J Abdullaf1, B Brendorp, C Torp-Pedersen and L Køber on behalf of the TRACE study group

Department of Cardiology P, Gentofte University Hospital, Copenhagen, Denmark

revised August 15, 2000; accepted August 16, 2000

Abstract

Aims To compare the outcome of short- and long-term survival of patients with Q wave vs non-Q wave myocardial infarction.

Methods A total of 6676 patients with acute myocardial infarction were enrolled on the TRAndolapril Cardiac Evaluation (TRACE) register between 1990 and 1992. Medical history, electrocardiographic diagnosis of Q wave and non-Q wave myocardial infarction, echocardiographic estimation of left ventricular systolic function determined as wall motion index, infarct complications, and survival were documented. The factors influencing the post-myocardial infarction outcome of these patients were studied after 30 days and after 8 years of follow-up, respectively.

Results Cox proportional-hazard models demonstrated that the electrocardiographic Q waves had significant influence on survival during the first 30 days [risk ratio 1·4 (95% confidence limits 1·2–1·7)] but no influence thereafter [1·0 (0·9–1·1)]. The result was the same in univariate and multivariate analyses. Subgroup analysis defined by age, sex, wall motion index, presence of congestive heart failure, diabetes mellitus, arterial hypertension, subsequent myocardial infarctions and use of thrombolytic therapy did not disclose importance of Q waves on mortality.

Conclusion The electrocardiographic presence of Q waves is associated with increased mortality during the initial 30 days after a myocardial infarction, but has no influence thereafter.

Key Words: Myocardial infarction, Q wave, short-term, long-term

f1 Correspondence: Jawdat Abdulla, Lyøvej 18, 3.TV, DK-2000 Copenhagen F, Denmark.

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