Comparison of clinical features of non-Q wave and Q wave myocardial infarction

Ogawa, Hisao; Hiramori, Katsuhiko; Haze, Kazuo; Saito, Muneyasu; Sumiyoshi, Tetsuya; Fukami, Kenichi; Goto, Yoichi; Ikeda, Masao

doi:10.1016/0002-8703(86)90056-6

Cited by 50 publications

(9 citation statements)

References 24 publications

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“…Assessment of infarct size by myocardial enzyme determination (creati nine kinase, CK. and CK-MB) have revealed that although absolute CK values may be higher in men [10,31], these differences are not significant when adjusted for the smaller body surface area of women [10], Non-Q wave myocardial infarction (pre viously described 'nontransmural' myocar dial infarction) occurs in a higher percentage of women than of men [11,32,[53][54][55][56], Although some authors have not found gen der-related differences in the incidence of non-Q wave myocardial infarction [56][57][58], a review of several studies points out that a greater percentage of women experience non-Q wave myocardial infarctions com pared with men, by almost 6% [56], Patients with non-Q wave myocardial infarctions have less left ventricular dysfunction [32,53,58], and better in hospital survival [53][54][55], However, the long-term prognosis is the same as in those patients who were dis charged after a Q wave myocardial infarc tion [53][54][55]59], Although non-Q wave myo cardial infarction survivors initially have less extensive myocardial damage [32,53,58], they have more recurrent myocardial infarctions [53. 58], which may account for an equivalent long-term prognosis with Q wave infarcts.…”

Section: Characteristicsmentioning

confidence: 99%

Myocardial Infarction in Women

Hendel¹

1990

Cardiology

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Cardiovascular disease is the leading cause of mortality in the United States regardless of gender. Women infrequently present with myocardial infarction as the initial presentation of coronary heart disease and have unrecognized infarctions more frequently than men. Myocardial infarction in women has a similar clinical presentation as in men, with the exception of an increased incidence of non-Q wave myocardial infarctions. Complications of acute infarction in women are probably similar although the majority of data has been drawn from studies involving predominantly men. Women do however experience more strokes and have less postinfarction pericarditis than their male counterparts. Left ventricular function remains the key prognostic determinant in both sexes. Recurrent infarction is increased in women with resultant elevated mortality rates. However, complex ventricular ectopy following myocardial infarction is not predictive of cardiovascular mortality in women. Early and late survival is decreased in women, an effect probably related to the increase in mean age of women as compared with men. Overall, gender distinctions are not usually made in the majority of studies involving myocardial infarction. As epidemiologic, pathophysiologic and clinical factors may be different regarding heart disease in women, further research in this important area is warranted.

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Section: Characteristicsmentioning

confidence: 99%

Myocardial Infarction in Women

Hendel¹

1990

Cardiology

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“…Of patients developing heart failure after infarction, only 25% have had a non-Q-wave infarction; of patients with cardiogenic shock, only 18% have had a non-Qwave infarction [3]. On the other hand, the reinfarction rate is high after non-Q-wave infarction.…”

Section: Opinion Statementmentioning

confidence: 98%

Non-Q-Wave myocardial infarction

Coppola

Ambrose

2000

Curr Treat Options Cardio Med

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The treatment of non-Q-wave infarction involves the use of antithrombotic therapy (aspirin and heparin) along with appropriate antianginal medication to reduce myocardial oxygen demands and prevent coronary spasm. In certain high-risk patient subgroups (ie, those with recurrent ischemia, persistent or significant ST segment change, congestive heart failure, or hypotension with chest pain), the use of newer agents such as the platelet glycoprotein IIb/IIIa antagonists is indicated. The role of angiography appears to be changing. In the past, at least in the United States, angiography was performed on nearly all patients with non-Q-wave infarction. Now, risk stratification into high- and low-risk subgroups can be performed based on clinical criteria. In low-risk individuals, we recommend that noninvasive testing be performed before a decision is made about an invasive evaluation. In high-risk patients, it is appropriate to perform angiography and, based on the angiographic findings, to provide appropriate therapy. Although the results of the Veterans Affairs Non-Q-Wave Infarction Strategies in Hospital (VANQWISH) study suggest that if bypass surgery is required, it should not be performed acutely, we do not believe that this is necessarily correct. Therapy must be individualized based on the risk-benefit profile of acute revascularization. Furthermore, the use of percutaneous coronary intervention, particularly with the glycoprotein IIb/IIIa antagonists and stents, is expanding to include multivessel disease, even in the presence of left ventricular dysfunction. Again, we believe therapy must be individualized to include an estimate of short- and long-term risk versus benefit. In the future, however, more data from appropriately designed clinical trials will be required to establish evidence-based therapy.

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“…The incidence of anterior myocardial infarction occurs equally in men and women [4,5,50,55,56], however, there have been slight differ ences noted for anterior myocardial infarcts, in that the anteroseptal and anterolateral regions are involved in 15% of women as compared with only 5% of men [4], There is controversy whether women experience more 'non-Q wave' myocardial infarctions compared to men. Some studies have favored a higher percentage of women [5,21,[57][58][59][60][61] while other authors have not found signifi cant gender differences [24,60,62,63], Patients with non-Q-wave infarcts are frequently older than patients with Q-wave myocardial infarctions [57,59] which may explain the possible increased preponderance of non-Qwave myocardial infarction [3,4,6,20]. A non-Q-wave myocardial infarction usually results in less ventricular dysfunction and lower hospital mortality.…”

Section: Clinical Presentationmentioning

confidence: 99%

“…A non-Q-wave myocardial infarction usually results in less ventricular dysfunction and lower hospital mortality. However, the prognosis for non-Q-wave myocardial infarction is not different [57][58][59]64], as there is an increased incidence of recurrent myocardial infarction [57,63].…”

Section: Clinical Presentationmentioning

confidence: 99%

Myocardial Infarction in Women

Mendelson

Hendel²

1995

Cardiology

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The leading cause of death in the United States is cardiovascular disease, regardless of gender. Women will more often have angina preceding their first myocardial infarct, but have more unrecognized infarctions than men. Women will be older, have more concomitant disease and present later in the course of their acute myocardial infarction. Although myocardial infarction may have similar clinical presentations in men and women, there are some important differences such as an increased incidence of non Q-wave myocardial infarctions in women, and the higher rate of complication and immortality from a myocardial infarct. Women develop less collateral cardiac vessels, which may explain the increased rate of hemodynamic complications after a myocardial infarct. Both early and late survival rates are also affected by the advanced mean age of women when they do present with a myocardial infarct. There is less data regarding treatment modalities based upon gender differences but in general, it appears that women benefit from established treatment modalities in the acute setting and subsequent to the event. It has been determined that there are epidemiologic differences, but pathophysiologic and clinical factors specific to women in this setting have yet to be determined.

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Comparison of clinical features of non-Q wave and Q wave myocardial infarction

Cited by 50 publications

References 24 publications

Myocardial Infarction in Women

Myocardial Infarction in Women

Non-Q-Wave myocardial infarction

Myocardial Infarction in Women

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