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      The Prognostic Implications of Negative T Waves in the Leads with ST Segment Elevation on Admission in Acute Myocardial Infarction

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          We assessed the prognostic significance of negative T waves on admission in leads with ST elevation in 2,853 patients with acute myocardial infarction treated with thrombolysis. Patients were classified into 2 groups based on the presence of negative (T–) or positive (T+) T waves in the leads with ST elevation on admission. T+ and T– waves on admission were detected in 2,601 (91%) and 252 (9%) patients, respectively. T– waves were observed in 6.7 and 9.6% of patients admitted ≤2 and 2–6 h after onset of infarction, respectively. There was a difference in prognosis between patients admitted ≤2 and >2 h after symptom onset. T– patients admitted ≤2 h after onset had no hospital mortality (0/52 patients), as compared to a 5.0% mortality rate in T+ patients (36/726 patients; p = 0.19). T– patients treated >2 h after onset suffered higher mortality (20/196 patients; 10.2%) than T+ patients (100/1,836 patients; 5.4%; p = 0.01). Multivariate analysis of the data on patients treated >2 h after onset demonstrated T– waves to be associated with mortality (OR 1.86; 95% CI 1.07–3.25; p = 0.017). T– waves in leads with ST elevation upon admission are associated with adverse prognosis in patients presenting >2 h after symptom onset, whereas in patients presenting ≤2 h after first symptoms, T– waves may be associated with better prognosis.

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          Author and article information

          S. Karger AG
          February 2000
          07 March 2000
          : 92
          : 2
          : 121-127
          aRabin Medical Center, Beilinson Campus, Petah-Tiqva, bSheba Medical Center, Tel-Hashomer, cTel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; dDuke Clinical Research Institute, Durham, N.C., USA
          6959 Cardiology 1999;92:121–127
          © 2000 S. Karger AG, Basel

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          Page count
          Figures: 1, Tables: 7, References: 12, Pages: 7
          Coronary Care


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