Q wave and non-Q wave myocardial infarction after thrombolysis
We studied the clinical outcome of Q wave and non-Q wave infarction after thrombolytic therapy. Controversy exists over the clinical significance of Q waves after thrombolysis. We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 patients with acute myoca...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1995-11, Vol.26 (6), p.1445-1451 |
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| container_title | Journal of the American College of Cardiology |
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| creator | Matetzky, Shlomi Barabash, Gabriel I. Rabinowitz, Babeth Rath, Shmuel Zahav, Yedael Har Agranat, Oren Kaplinsky, Elieser Hod, Hanoch |
| description | We studied the clinical outcome of Q wave and non-Q wave infarction after thrombolytic therapy.
Controversy exists over the clinical significance of Q waves after thrombolysis.
We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 patients with acute myocardial infarction classified as Q wave and non-Q wave on the 24-h and discharge electrocardiograms (ECGs). The results from the two groups were then compared.
Eighty percent of patients had a Q wave and 20% a non-Q wave infarction on the 24-h ECG. The latter patients had lower peak creatine kinase (CK) levels (p < 0.001), but the two groups did not differ significantly otherwise. In 18 patients with a Q wave infarction on the 24-h ECG, pathologic Q waves disappeared. However, in seven patients with a non-Q wave infarction on the 24-h ECG, pathologic Q waves appeared throughout the hospital period. Q wave regression was associated with lower peak CK levels (p < 0.001) and an improvement in left ventricular ejection fraction (p < 0.01). Thus, only 72% of patients had a Q wave and 28% a non-Q wave infarction on the discharge ECG. Patients with a non-Q wave infarction on the discharge ECG had higher patency of the infarct-related artery (p < 0.04), lower mean peak CK levels (p < 0.0001), a higher ejection fraction (p = 0.001) and a lower incidence of heart failure (p = 0.06) than patients with a Q wave infarction on the discharge ECG. Although the 2-year incidence of reinfarction and revascularization was higher in patients with a non-Q wave infarction on the discharge ECG (p < 0.05), 2-year mortality was lower (p = 0.08).
Although the early postthrombolytic distinction between Q wave and non-Q wave infarction conveys no significant information, during the hospital period, non-Q wave infarction is associated with a smaller infarct area, improved left ventricular function and lower mortality. |
| doi_str_mv | 10.1016/0735-1097(95)00346-0 |
| format | Article |
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Controversy exists over the clinical significance of Q waves after thrombolysis.
We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 patients with acute myocardial infarction classified as Q wave and non-Q wave on the 24-h and discharge electrocardiograms (ECGs). The results from the two groups were then compared.
Eighty percent of patients had a Q wave and 20% a non-Q wave infarction on the 24-h ECG. The latter patients had lower peak creatine kinase (CK) levels (p < 0.001), but the two groups did not differ significantly otherwise. In 18 patients with a Q wave infarction on the 24-h ECG, pathologic Q waves disappeared. However, in seven patients with a non-Q wave infarction on the 24-h ECG, pathologic Q waves appeared throughout the hospital period. Q wave regression was associated with lower peak CK levels (p < 0.001) and an improvement in left ventricular ejection fraction (p < 0.01). Thus, only 72% of patients had a Q wave and 28% a non-Q wave infarction on the discharge ECG. Patients with a non-Q wave infarction on the discharge ECG had higher patency of the infarct-related artery (p < 0.04), lower mean peak CK levels (p < 0.0001), a higher ejection fraction (p = 0.001) and a lower incidence of heart failure (p = 0.06) than patients with a Q wave infarction on the discharge ECG. Although the 2-year incidence of reinfarction and revascularization was higher in patients with a non-Q wave infarction on the discharge ECG (p < 0.05), 2-year mortality was lower (p = 0.08).
Although the early postthrombolytic distinction between Q wave and non-Q wave infarction conveys no significant information, during the hospital period, non-Q wave infarction is associated with a smaller infarct area, improved left ventricular function and lower mortality.]]></description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/0735-1097(95)00346-0</identifier><identifier>PMID: 7594069</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Biological and medical sciences ; Cardiac dysrhythmias ; Cardiology. Vascular system ; Coronary Angiography ; Electrocardiography ; Female ; Heart ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - diagnosis ; Myocardial Infarction - drug therapy ; Myocardial Infarction - physiopathology ; Radionuclide Ventriculography ; Thrombolytic Therapy ; Time Factors ; Treatment Outcome</subject><ispartof>Journal of the American College of Cardiology, 1995-11, Vol.26 (6), p.1445-1451</ispartof><rights>1995 American College of Cardiology</rights><rights>1996 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c487t-180640ed631738b72a9c46b2199f52beb9fcc4e3e13c6377b1c137288e77fa7c3</citedby><cites>FETCH-LOGICAL-c487t-180640ed631738b72a9c46b2199f52beb9fcc4e3e13c6377b1c137288e77fa7c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/0735-1097(95)00346-0$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,45997</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2906584$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/7594069$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Matetzky, Shlomi</creatorcontrib><creatorcontrib>Barabash, Gabriel I.</creatorcontrib><creatorcontrib>Rabinowitz, Babeth</creatorcontrib><creatorcontrib>Rath, Shmuel</creatorcontrib><creatorcontrib>Zahav, Yedael Har</creatorcontrib><creatorcontrib>Agranat, Oren</creatorcontrib><creatorcontrib>Kaplinsky, Elieser</creatorcontrib><creatorcontrib>Hod, Hanoch</creatorcontrib><title>Q wave and non-Q wave myocardial infarction after thrombolysis</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description><![CDATA[We studied the clinical outcome of Q wave and non-Q wave infarction after thrombolytic therapy.
Controversy exists over the clinical significance of Q waves after thrombolysis.
We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 patients with acute myocardial infarction classified as Q wave and non-Q wave on the 24-h and discharge electrocardiograms (ECGs). The results from the two groups were then compared.
Eighty percent of patients had a Q wave and 20% a non-Q wave infarction on the 24-h ECG. The latter patients had lower peak creatine kinase (CK) levels (p < 0.001), but the two groups did not differ significantly otherwise. In 18 patients with a Q wave infarction on the 24-h ECG, pathologic Q waves disappeared. However, in seven patients with a non-Q wave infarction on the 24-h ECG, pathologic Q waves appeared throughout the hospital period. Q wave regression was associated with lower peak CK levels (p < 0.001) and an improvement in left ventricular ejection fraction (p < 0.01). Thus, only 72% of patients had a Q wave and 28% a non-Q wave infarction on the discharge ECG. Patients with a non-Q wave infarction on the discharge ECG had higher patency of the infarct-related artery (p < 0.04), lower mean peak CK levels (p < 0.0001), a higher ejection fraction (p = 0.001) and a lower incidence of heart failure (p = 0.06) than patients with a Q wave infarction on the discharge ECG. Although the 2-year incidence of reinfarction and revascularization was higher in patients with a non-Q wave infarction on the discharge ECG (p < 0.05), 2-year mortality was lower (p = 0.08).
Although the early postthrombolytic distinction between Q wave and non-Q wave infarction conveys no significant information, during the hospital period, non-Q wave infarction is associated with a smaller infarct area, improved left ventricular function and lower mortality.]]></description><subject>Aged</subject><subject>Biological and medical sciences</subject><subject>Cardiac dysrhythmias</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Angiography</subject><subject>Electrocardiography</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Myocardial Infarction - drug therapy</subject><subject>Myocardial Infarction - physiopathology</subject><subject>Radionuclide Ventriculography</subject><subject>Thrombolytic Therapy</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1995</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE1LxDAQhoMouq7-A4UeRPRQTZqv5rIgi1-wIIKeQ5pOMNI2mnRX9t_bdcsePQ3DPO_L8CB0RvANwUTcYkl5TrCSV4pfY0yZyPEemhDOy5xyJffRZIccoeOUPjHGoiTqEB1KrhgWaoJmr9mPWUFmujrrQpePa7sO1sTamybznTPR9j50mXE9xKz_iKGtQrNOPp2gA2eaBKfjnKL3h_u3-VO-eHl8nt8tcstK2eekxIJhqAUlkpaVLIyyTFQFUcrxooJKOWsZUCDUCiplRSyhsihLkNIZaekUXW57v2L4XkLqdeuThaYxHYRl0lIKpoa6AWRb0MaQUgSnv6JvTVxrgvVGm9440RsnWnH9p03jIXY-9i-rFupdaPQ03C_Gu0nWNC6azvq0wwqFBS_ZgM22GAwuVh6iTtZDZ6H2EWyv6-D__-MXA_6Hog</recordid><startdate>19951115</startdate><enddate>19951115</enddate><creator>Matetzky, Shlomi</creator><creator>Barabash, Gabriel I.</creator><creator>Rabinowitz, Babeth</creator><creator>Rath, Shmuel</creator><creator>Zahav, Yedael Har</creator><creator>Agranat, Oren</creator><creator>Kaplinsky, Elieser</creator><creator>Hod, Hanoch</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19951115</creationdate><title>Q wave and non-Q wave myocardial infarction after thrombolysis</title><author>Matetzky, Shlomi ; Barabash, Gabriel I. ; Rabinowitz, Babeth ; Rath, Shmuel ; Zahav, Yedael Har ; Agranat, Oren ; Kaplinsky, Elieser ; Hod, Hanoch</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c487t-180640ed631738b72a9c46b2199f52beb9fcc4e3e13c6377b1c137288e77fa7c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1995</creationdate><topic>Aged</topic><topic>Biological and medical sciences</topic><topic>Cardiac dysrhythmias</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Angiography</topic><topic>Electrocardiography</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Myocardial Infarction - drug therapy</topic><topic>Myocardial Infarction - physiopathology</topic><topic>Radionuclide Ventriculography</topic><topic>Thrombolytic Therapy</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Matetzky, Shlomi</creatorcontrib><creatorcontrib>Barabash, Gabriel I.</creatorcontrib><creatorcontrib>Rabinowitz, Babeth</creatorcontrib><creatorcontrib>Rath, Shmuel</creatorcontrib><creatorcontrib>Zahav, Yedael Har</creatorcontrib><creatorcontrib>Agranat, Oren</creatorcontrib><creatorcontrib>Kaplinsky, Elieser</creatorcontrib><creatorcontrib>Hod, Hanoch</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Matetzky, Shlomi</au><au>Barabash, Gabriel I.</au><au>Rabinowitz, Babeth</au><au>Rath, Shmuel</au><au>Zahav, Yedael Har</au><au>Agranat, Oren</au><au>Kaplinsky, Elieser</au><au>Hod, Hanoch</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Q wave and non-Q wave myocardial infarction after thrombolysis</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1995-11-15</date><risdate>1995</risdate><volume>26</volume><issue>6</issue><spage>1445</spage><epage>1451</epage><pages>1445-1451</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract><![CDATA[We studied the clinical outcome of Q wave and non-Q wave infarction after thrombolytic therapy.
Controversy exists over the clinical significance of Q waves after thrombolysis.
We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 patients with acute myocardial infarction classified as Q wave and non-Q wave on the 24-h and discharge electrocardiograms (ECGs). The results from the two groups were then compared.
Eighty percent of patients had a Q wave and 20% a non-Q wave infarction on the 24-h ECG. The latter patients had lower peak creatine kinase (CK) levels (p < 0.001), but the two groups did not differ significantly otherwise. In 18 patients with a Q wave infarction on the 24-h ECG, pathologic Q waves disappeared. However, in seven patients with a non-Q wave infarction on the 24-h ECG, pathologic Q waves appeared throughout the hospital period. Q wave regression was associated with lower peak CK levels (p < 0.001) and an improvement in left ventricular ejection fraction (p < 0.01). Thus, only 72% of patients had a Q wave and 28% a non-Q wave infarction on the discharge ECG. Patients with a non-Q wave infarction on the discharge ECG had higher patency of the infarct-related artery (p < 0.04), lower mean peak CK levels (p < 0.0001), a higher ejection fraction (p = 0.001) and a lower incidence of heart failure (p = 0.06) than patients with a Q wave infarction on the discharge ECG. Although the 2-year incidence of reinfarction and revascularization was higher in patients with a non-Q wave infarction on the discharge ECG (p < 0.05), 2-year mortality was lower (p = 0.08).
Although the early postthrombolytic distinction between Q wave and non-Q wave infarction conveys no significant information, during the hospital period, non-Q wave infarction is associated with a smaller infarct area, improved left ventricular function and lower mortality.]]></abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7594069</pmid><doi>10.1016/0735-1097(95)00346-0</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Biological and medical sciences Cardiac dysrhythmias Cardiology. Vascular system Coronary Angiography Electrocardiography Female Heart Humans Male Medical sciences Middle Aged Myocardial Infarction - diagnosis Myocardial Infarction - drug therapy Myocardial Infarction - physiopathology Radionuclide Ventriculography Thrombolytic Therapy Time Factors Treatment Outcome |
| title | Q wave and non-Q wave myocardial infarction after thrombolysis |
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