Defining unrecognized myocardial infarction: A call for standardized electrocardiographic diagnostic criteria

Ammar, Khawaja Afzal; Kors, Jan A.; Yawn, Barbara P.; Rodeheffer, Richard J.

doi:10.1016/j.ahj.2004.03.019

Cited by 62 publications

(48 citation statements)

References 29 publications

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“…Secondly, MC was coded by visual reading in our study. Computerized ECG analysis is reportedly superior to visual reading for better reliability 28) ; however, ECG reading in this study was performed under the best standardized quality control in 1980. Third, we could not assess the risk of q wave abnormalities according to the lead in which q waves were present to evaluate their clinical meaning because there were no data concerning the lead in the baseline survey.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Q Wave for Cardiovascular Death in a 19-Year Prospective Study of the Japanese General Population

Higashiyama

Hozawa

Murakami

et al. 2009

JAT

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Aim:Little is known about the prognostic value of q wave abnormality for cardiovascular disease (CVD) on a resting electrocardiogram (ECG) of the Japanese general population with an extremely low incidence of myocardial infarction. Methods: We followed 8,339 participants without a past and present history of CVD for 19 years. The multivariate-adjusted hazard ratio (HR) of q wave abnormality for CVD mortality was estimated by the Cox proportional hazards model. Results: The multivariate-adjusted HR of composite findings of moderate or severe q wave abnormality was 1.75 (95% confidence interval (CI): 0.97 − 3.17) for mortality due to CVD and 2.97 (95%CI: 1.43 − 6.16) due to heart diseases. The multivariate-adjusted HR of mild abnormality for mortality from heart diseases was 1.95 (95%CI: 1.00 − 3.81). The relationship between moderate or severe abnormalities and mortality from CVD was unchanged when participants with ST-T changes and high amplitude R waves were excluded and when participants were divided by the presence of major CVD risk factors such as hypertension. Q wave abnormality was not associated with the risk of stroke. Conclusion: Moderate or severe q wave abnormalities are prominent and important predictors of mortality due to CVD and heart disease in the Japanese general population without CVD history.

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Section: Discussionmentioning

confidence: 99%

Prognostic Value of Q Wave for Cardiovascular Death in a 19-Year Prospective Study of the Japanese General Population

Higashiyama

Hozawa

Murakami

et al. 2009

JAT

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“…36 In addition, previous studies suggest that the long-term cardiovascular prognosis of individuals with silent MI may be similar to that of subjects with recognized MI. 39 -43 Individuals with ECG Q waves, the most commonly used method to detect unrecognized MIs, 44 have been excluded from the present analysis, but this would not rule out all silent MIs, because imaging studies have greater sensitivity for detecting transmural or partial-thickness scar than do ECG Q waves. 45,46 Detection of segmental LV WM abnormality improved risk stratification even after adjustment for the effect of low LV ejection fraction in the present analyses.…”

Section: Wm Abnormalities and Prediction Of Cardiovascular Outcomementioning

confidence: 99%

Prevalence and Prognostic Significance of Wall-Motion Abnormalities in Adults Without Clinically Recognized Cardiovascular Disease

et al. 2007

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Background-Left ventricular wall motion (WM) abnormalities have recognized prognostic significance in patients with coronary or other heart diseases; however, whether abnormal WM predicts adverse events in adults without overt cardiovascular disease has not been assessed. Our objective was to determine whether echocardiographic WM abnormalities predict subsequent cardiovascular events in a population-based sample. Methods and Results-Participants (nϭ2864, mean age 60Ϯ8 years, 64% women) without clinically evident cardiovascular disease in the second Strong Heart Study examination who had complete echocardiographic WM assessment were studied. Echocardiographic assessment revealed that 5% of participants (nϭ140) had focal hypokinesia, and 1.5% (nϭ42) had WM abnormalities. Relationships between WM abnormalities and fatal and nonfatal cardiovascular events (including myocardial infarction, stroke, coronary artery disease, and heart failure; nϭ554) and cardiovascular death (nϭ182) during 8Ϯ2 years follow-up were examined. In Cox regression, after adjustment for age, gender, waist/hip ratio, systolic blood pressure, and diabetes mellitus, segmental WM abnormalities were associated with a 2.5-fold higher risk of cardiovascular events and a 2.6-fold higher risk of cardiovascular death (both PϽ0.0001). In similar multivariable models, global WM abnormalities were associated with a 2.4-fold higher risk of cardiovascular events (Pϭ0.001) and a 3.4-fold higher risk of cardiovascular death (Pϭ0.003). Conclusions-Echocardiographic

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“…As shown in the Table, these results have been confirmed by reports from other investigators in locations ranging from Honolulu and Reykjavik to Israel and the Bronx, with UMI prevalence rates largely related to age and ranging from approximately 4% to 44% of all infarctions. 3,4 Remarkably, with the exception of the Israeli Ischemic Heart Disease Study, all-cause death rates were similar in recognized MI and UMI in all of these reports.…”

Section: Unrecognized Myocardial Infarctionmentioning

confidence: 68%

Recognizing Unrecognized Risk

Owens

Plehn

2007

Circulation

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Defining unrecognized myocardial infarction: A call for standardized electrocardiographic diagnostic criteria

Cited by 62 publications

References 29 publications

Prognostic Value of Q Wave for Cardiovascular Death in a 19-Year Prospective Study of the Japanese General Population

Prognostic Value of Q Wave for Cardiovascular Death in a 19-Year Prospective Study of the Japanese General Population

Prevalence and Prognostic Significance of Wall-Motion Abnormalities in Adults Without Clinically Recognized Cardiovascular Disease

Recognizing Unrecognized Risk

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