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Is
Microvolt T-Wave Alternans a universal marker for prediction of cardiac
events after acute MI ? |
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Presentation
Start/End Time: |
Thursday,
May 10, 2007, 3:30 PM - 4:30 PM |
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Location: |
Exhibit
Hall |
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Author
Block: |
Artur
T. Filipecki, MD, PhD, Krystian Wita, MD, PhD, Zbigniew Tabor, MD, Jaroslaw
Myszor, MD, PhD, Maciej Turski, MD, Jan Szczogiel, MD and Maria Trusz-Gluza,
MD, PhD. I Department of Cardiology, Silesian Medical University, Katowice,
Poland, I Dep. of Cardiology, Silesian Medical University, Katowice, Poland |
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Introduction:
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. Methods: In prospective mode 115 consecutive patients with acute
anteriorMI 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’s occurred at 18 months (9 cardiac
deaths including 5 sudden, 3 reinfarctions, 1 sustained VT and 14
rehospitalizations for HF).The best Cox regression model for MACE prediction
data are presented in table 1. When analyzed for cardiac deaths and sudden
cardiac deaths, the only common factor present in models was not negative
MTWA. Conclusions: Not negative MTWA test result in combination with other
parameters is a powerful predictor of death, sudden death nad major cardiac
events in patients after acute MI treated with early PCI.
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