![]() Received: AugAccepted: FebruPublished: April 21, 2009Ĭopyright: © 2009 Kim et al. PLoS Med 6(4):Įditor: Anushka Patel, University of Sydney, Australia (2009) Unrecognized Non-Q-Wave Myocardial Infarction: Prevalence and Prognostic Significance in Patients with Suspected Coronary Disease. Multivariable analysis including New York Heart Association class and LVEF demonstrated that non-Q-wave UMI was an independent predictor of all-cause mortality (hazard ratio 11.4, 95% confidence interval 2.5–51.1) and cardiac mortality (HR 17.4, 95% CI 2.2–137.4).Ĭitation: Kim HW, Klem I, Shah DJ, Wu E, Meyers SN, Parker MA, et al. Over 2.2 y (interquartile range 1.8–2.7), 16 deaths occurred: 13 in non-Q-wave UMI patients (26%), one in Q-wave UMI (7%), and two in patients without MI (2%). The prevalence of non-Q-wave UMI increased with the extent and severity of coronary disease on angiography ( p<0.0001 for both). Infarct size in non-Q-wave UMI was modest (8%☗% of left ventricular mass), and left ventricular ejection fraction (LVEF) by cine-CMR was usually preserved (52%☑8%). Patients with non-Q-wave UMI were older, were more likely to have diabetes, and had higher Framingham risk than those without MI, but were similar to those with Q-wave UMI. The prevalence of non-Q-wave UMI was 27% (50/185), compared with 8% (15/185) for Q-wave UMI. The primary endpoint was all-cause mortality. Patients were followed to determine the prognostic significance of non-Q-wave UMI. Non-Q-wave UMI was identified by DE-CMR in the absence of electrocardiographic Q-waves. Q-wave UMI was determined by electrocardiography (Minnesota Code). We conducted a prospective study of 185 patients with suspected coronary disease and without history of clinical myocardial infarction who were scheduled for invasive coronary angiography. ![]()
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