|
Is microvolt T-wave alternans a universal marker for
prediction of cardiac events after acute MI? |
||||||||||||||||||||||||||
|
Authors: |
||||||||||||||||||||||||||
|
Topic(s): |
||||||||||||||||||||||||||
|
Citation: |
||||||||||||||||||||||||||
|
The era of early primary coronary
intervention (PCI) for acute MI has changed the patients outcome, thus we
undertook study to assess prognostic value of microvolt T-wave alternans
(MTWA) and other established risk indices in these settings. In the prospective mode 115 consecutive
patients with the first, acute anterior MI undergoing PCI <12 hours from
the onset of symptoms, with successful LAD opening, treated according to
current guidelines were enrolled. Demographics, established and recently
proposed risk factors, as well as index event data were assessed. Major
adverse cardiac events (MACE) - death, recurrent MI, malignant ventricular
arrhythmias and rehospitalization due to heart failure - were recorded during
18 month follow-up. At 30 days MTWA test was performed. Results: 27 MACE episodes occurred at 18 months (9 cardiac deaths including 5 sudden,
3 reinfarctions, 1 sustained VT and 14 rehospitalizations for HF). The best
logistic regression analysis model is shown in table 1. When analyzed for cardiac deaths and
sudden cardiac deaths, the only common factor present in logistic regression
models was the presence of not negative MTWA. Conclusions: Not negative MTWA test result in combination with other parameters is
a powerful predictor of death, sudden death and major cardiac events in
patients after acute MI. |
||||||||||||||||||||||||||
|
Table 1} |
||||||||||||||||||||||||||
|