Research ExplorerPublicationsPredictive Value of Serial ECGs in Patients with Suspected M...

Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction

Standard

Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction. / Lehmacher, Jonas; Neumann, Johannes Tobias; Sörensen, Nils Arne; Goßling, Alina; Haller, Paul Michael; Hartikainen, Tau Sarra; Clemmensen, Peter; Zeller, Tanja; Blankenberg, Stefan; Westermann, Dirk.

In: J CLIN MED, Vol. 9, No. 7, 20.07.2020.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Lehmacher, J, Neumann, JT, Sörensen, NA, Goßling, A, Haller, PM, Hartikainen, TS, Clemmensen, P, Zeller, T, Blankenberg, S & Westermann, D 2020, 'Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction', J CLIN MED, vol. 9, no. 7. https://doi.org/10.3390/jcm9072303

APA

Lehmacher, J., Neumann, J. T., Sörensen, N. A., Goßling, A., Haller, P. M., Hartikainen, T. S., Clemmensen, P., Zeller, T., Blankenberg, S., & Westermann, D. (2020). Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction. J CLIN MED, 9(7). https://doi.org/10.3390/jcm9072303

Vancouver

Lehmacher J, Neumann JT, Sörensen NA, Goßling A, Haller PM, Hartikainen TS et al. Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction. J CLIN MED. 2020 Jul 20;9(7). https://doi.org/10.3390/jcm9072303

Bibtex

@article{26880a55be414a0389cdd7a83fa4acb0,
title = "Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction",
abstract = "The electrocardiogram (ECG) is an important diagnostic tool for patients with suspected acute myocardial infarction (AMI). Current guidelines recommend serial ECGs in case of persisting symptoms. We aimed to analyze the predictive value of ischemic ECG-signs in patients with suspected AMI. Patients presenting to the emergency department with suspected AMI were included. All patients with ST-elevation AMI were excluded from analyses. Patients received 12-lead-ECG and high-sensitive Troponin T (hs-TnT)-measurement at admission and after 3 h. Four groups were defined: no ischemic signs in either ECG; new ischemic signs in the second ECG; resolved ischemic signs in the second ECG; and persistent ischemic signs in both ECGs. Patients were followed for 2 years to assess the composite endpoint of all-cause-mortality, AMI, and coronary revascularization. Using a 30-day landmark analysis, a Cox regression with ischemic signs as the variable of interest, adjusted by cardiovascular risk factors, was calculated. Of 1675 patients, 1321 showed no ischemic signs, in 25 new-, in 92 resolved- and in 237 patients, persistent ischemic signs were documented. Patients with persistent ischemic signs had significantly worse outcomes, compared to those without. Compared to no ischemic signs, adjusted hazard ratios for the combined endpoint were 0.81 (95% CI 0.20, 3.31; p-value = 0.77) for new-, 0.59 (95% CI 0.26, 1.34; p-value = 0.21) for resolved-, and 1.47 (95% CI 1.102, 2.13; p-value = 0.041) for persistent ischemic signs. In patients with suspected AMI, persistent ischemic ECG-signs are predictive of a higher rate of all-cause-mortality, AMI, and revascularization.",
author = "Jonas Lehmacher and Neumann, {Johannes Tobias} and S{\"o}rensen, {Nils Arne} and Alina Go{\ss}ling and Haller, {Paul Michael} and Hartikainen, {Tau Sarra} and Peter Clemmensen and Tanja Zeller and Stefan Blankenberg and Dirk Westermann",
year = "2020",
month = jul,
day = "20",
doi = "10.3390/jcm9072303",
language = "English",
volume = "9",
journal = "J CLIN MED",
issn = "2077-0383",
publisher = "MDPI AG",
number = "7",

}

RIS

TY - JOUR

T1 - Predictive Value of Serial ECGs in Patients with Suspected Myocardial Infarction

AU - Lehmacher, Jonas

AU - Neumann, Johannes Tobias

AU - Sörensen, Nils Arne

AU - Goßling, Alina

AU - Haller, Paul Michael

AU - Hartikainen, Tau Sarra

AU - Clemmensen, Peter

AU - Zeller, Tanja

AU - Blankenberg, Stefan

AU - Westermann, Dirk

PY - 2020/7/20

Y1 - 2020/7/20

N2 - The electrocardiogram (ECG) is an important diagnostic tool for patients with suspected acute myocardial infarction (AMI). Current guidelines recommend serial ECGs in case of persisting symptoms. We aimed to analyze the predictive value of ischemic ECG-signs in patients with suspected AMI. Patients presenting to the emergency department with suspected AMI were included. All patients with ST-elevation AMI were excluded from analyses. Patients received 12-lead-ECG and high-sensitive Troponin T (hs-TnT)-measurement at admission and after 3 h. Four groups were defined: no ischemic signs in either ECG; new ischemic signs in the second ECG; resolved ischemic signs in the second ECG; and persistent ischemic signs in both ECGs. Patients were followed for 2 years to assess the composite endpoint of all-cause-mortality, AMI, and coronary revascularization. Using a 30-day landmark analysis, a Cox regression with ischemic signs as the variable of interest, adjusted by cardiovascular risk factors, was calculated. Of 1675 patients, 1321 showed no ischemic signs, in 25 new-, in 92 resolved- and in 237 patients, persistent ischemic signs were documented. Patients with persistent ischemic signs had significantly worse outcomes, compared to those without. Compared to no ischemic signs, adjusted hazard ratios for the combined endpoint were 0.81 (95% CI 0.20, 3.31; p-value = 0.77) for new-, 0.59 (95% CI 0.26, 1.34; p-value = 0.21) for resolved-, and 1.47 (95% CI 1.102, 2.13; p-value = 0.041) for persistent ischemic signs. In patients with suspected AMI, persistent ischemic ECG-signs are predictive of a higher rate of all-cause-mortality, AMI, and revascularization.

AB - The electrocardiogram (ECG) is an important diagnostic tool for patients with suspected acute myocardial infarction (AMI). Current guidelines recommend serial ECGs in case of persisting symptoms. We aimed to analyze the predictive value of ischemic ECG-signs in patients with suspected AMI. Patients presenting to the emergency department with suspected AMI were included. All patients with ST-elevation AMI were excluded from analyses. Patients received 12-lead-ECG and high-sensitive Troponin T (hs-TnT)-measurement at admission and after 3 h. Four groups were defined: no ischemic signs in either ECG; new ischemic signs in the second ECG; resolved ischemic signs in the second ECG; and persistent ischemic signs in both ECGs. Patients were followed for 2 years to assess the composite endpoint of all-cause-mortality, AMI, and coronary revascularization. Using a 30-day landmark analysis, a Cox regression with ischemic signs as the variable of interest, adjusted by cardiovascular risk factors, was calculated. Of 1675 patients, 1321 showed no ischemic signs, in 25 new-, in 92 resolved- and in 237 patients, persistent ischemic signs were documented. Patients with persistent ischemic signs had significantly worse outcomes, compared to those without. Compared to no ischemic signs, adjusted hazard ratios for the combined endpoint were 0.81 (95% CI 0.20, 3.31; p-value = 0.77) for new-, 0.59 (95% CI 0.26, 1.34; p-value = 0.21) for resolved-, and 1.47 (95% CI 1.102, 2.13; p-value = 0.041) for persistent ischemic signs. In patients with suspected AMI, persistent ischemic ECG-signs are predictive of a higher rate of all-cause-mortality, AMI, and revascularization.

U2 - 10.3390/jcm9072303

DO - 10.3390/jcm9072303

M3 - SCORING: Journal article

C2 - 32698466

VL - 9

JO - J CLIN MED

JF - J CLIN MED

SN - 2077-0383

IS - 7

ER -