Abstract
The prognostic significance of the type of first acute myocardial infarction (Q wave versus non-Q wave) and Q wave location (anterior versus inferoposterior) was determined from a multicenter data base involving 777 placebo-treated patients who were participants in the Multicenter Diltiazem Post-Infarction Trial. There were 224 patients (29%) with a non-Q wave infarction, 326 (42%) with an inferoposterior Q wave infarction and 227 (29%) with an anterior Q wave infarction. Mean left ventricular ejection fraction was significantly (p < 0.001) lower in patients with an anterior Q wave infarction than in the other two groups (anterior Q wave 0.39; inferior Q wave 0.52; non-Q wave 0.53). Nevertheless, the total cardiac mortality rate during the follow-up period (average 25 months per patient) was only marginally higher (p = 0.42) in the anterior Q wave group (8.4%) than in the other two groups (inferoposterior Q wave 7.1%; non-Q wave 6.3%). The total first recurrent cardiac event was somewhat higher (p = 0.08) in the anterior Q wave group (18.1%) than in the other two groups (inferoposterior Q wave 11.7%; non-Q wave 15.6%). Survivorship analyses extending over 3 years revealed that electrocardiographic classification of the type of first infarction and Q wave location did not make significant independent contributions to the risk of postinfarction cardiac death or first recurrent cardiac event, either before or after adjustment for baseline clinical variables.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1201-1207 |
| Number of pages | 7 |
| Journal | Journal of the American College of Cardiology |
| Volume | 15 |
| Issue number | 6 |
| DOIs | |
| State | Published - 1990 |
Funding
From the Heart Research Follow-Up Program and the Division of Biostatistics, University of Rochester School of Medicine and Dentistry. Rochester, New York; the University of Arizona Health Sciences Center. Tucson. Arizona and St. Lukes/Roosevelt Hospital and Columbia University, New York. New York. 'See Ref. 18 for a full listing of the Multicenter Diltiazem Post-Infarction Research Group. This study was supported in part by a consortium grant from Godecke Aktiengesellschaft (Germany), Laboratories de Dr Esteve, SA (Spain), Marion Laboratories, Inc., Kansas City, Missouri (USA), Nordic Laboratories, Inc. (Canada), Lars Synthelabo (France), Tanabe Seiyaku Co., Ltd. (Japan) and Warner-Lambert International (USA), and by funds from the Flinn Foundation, Phoenix. Arizona.
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine