Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction.
Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction.
复制标题
下壁急性心肌梗死时心前区 ST 段压低的预后意义。
DOI：
10.1016/0002-9149(85)90369-8
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发表时间：
1985
期刊：
影响因子：
--
通讯作者：
Rosati,RA
中科院分区：
文献类型：
--
作者：
Hlatky,MA;Califf,RM;Lee,KL;Pryor,DB;Wagner,GS;Rosati,RA
为了研究下壁急性心肌梗死期间心前区 ST 段压低的机制和预后重要性，我们确定了 1969 年至 1982 年间入院的 162 名患者。根据 QRS 评分系统的评估，V1、V2 和 V3 导联 ST 压低的患者有明显更大的梗塞。无 ST 压低的患者的医院死亡率为 4%（75 名患者中的 3 名），而 ST 压低的患者的医院死亡率为 13%（87 名患者中的 11 名）。 ST 压低的数量与医院死亡率之间的关系显着（通过逻辑回归，p < 0.001），并且在调整其他潜在预后因素后仍然显着（p < 0.003）。在出院患者中，无心前区 ST 压低的患者的 5 年生存率为 92%，有心前区 ST 压低的患者的 5 年生存率为 80%（根据 Cox 模型，p = 0.058）。下壁急性心肌梗死时，入院心电图显示心前导 ST 段压低，提示梗塞范围较大，预示着较高的住院死亡率，并表明出院后的长期预后较差。
To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2and V3had significantly larger infarctions as assessed by a QRS scoring system. Hospital mortality was 4% (3 of 75) among patients without ST depression, and 13% (11 of 87) in patients with ST depression. The relation between the amount of ST depression and hospital mortality was significant (p < 0.001 by logistic regression), and remained significant (p < 0.003) after adjusting for other potentially prognostic factors. Among patients discharged from the hospital, the 5-year survival was 92% in those without precordial ST depression and 80% in those with precordial ST depression (p = 0.058 by the Cox model). Precordial ST-segment depression on the admission electrocardiogram during an inferior acute myocardial infarction indicates a larger infarction, predicts a higher hospital mortality and suggests a worse long-term prognosis after discharge.