Prognostic significance of precordial ST-segment depression during inferior acute myocardial infarction

• Published in: The American journal of cardiology Vol. 55; no. 4; pp. 325 - 329
• Main Authors: Hlatky, Mark A., Califf, Robert M., Lee, Kerry L., Pryor, David B., Wagner, Galen S., Rosati, Robert A.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-02-1985; Elsevier
• Subjects: Adult; Aged; Analysis of Variance; Biological and medical sciences; Cardiology. Vascular system; Coronary heart disease; Electrocardiography; Female; Heart; Heart Ventricles - physiopathology; Humans; Male; Medical sciences; Middle Aged; Myocardial Infarction - complications; Myocardial Infarction - mortality; Myocardial Infarction - physiopathology; Prognosis; Time Factors; Electrodiagnosis; Prognosis; Acute; Myocardium; Cardiovascular disease; ST depression; Coronary heart disease
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(85)90369-8

To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V
1, V
2 and V
3 had significantly larger infarctions as assessed by a QRS scoring system. Hospital mortality was 4% (3 of 75) among patients without ST depression, and 13% (11 of 87) in patients with ST depression. The relation between the amount of ST depression and hospital mortality was significant (p < 0.001 by logistic regression), and remained significant (p < 0.003) after adjusting for other potentially prognostic factors. Among patients discharged from the hospital, the 5-year survival was 92% in those without precordial ST depression and 80% in those with precordial ST depression (p = 0.058 by the Cox model). Precordial ST-segment depression on the admission electrocardiogram during an inferior acute myocardial infarction indicates a larger infarction, predicts a higher hospital mortality and suggests a worse long-term prognosis after discharge.