摘要
Aims: To investigate the prognostic value of T- wave abnormalities in patients with non- ST- segment elevation acute coronary syndromes(NSTE- ACS), and whether such ECG changes may predict benefit from an early coronary angiography. Although ST- segment changes are considered the most important ECG feature in NSTE- ACS, T- wave abnormalities are the most common ECG finding. We hypothesize that a new quantitative approach to T- wave analysis could improve the prognostic value of this ECG abnormality. Methods and results: Quantitative T- wave analysis was performed on the admission ECG in 1609 patients with NSTE- ACS. Nine different categories of T- wave abnormality were analysed for their prognostic value concerning clinical outcome in patients not randomized to early coronary angiography. Also, the presence of one category(i.e. T- wave abnormality in >6 leads)was analysed for its predictive value concerning benefit from early coronary angiography. The combined study endpoint was death or myocardial infarction at 1 year follow- up. Patients with >6 leads with abnormal T waves and concomitant ST- segment depression had a higher risk when not receiving early coronary angiography(24 vs. 12% , respectively; P=0.003), but could be brought to the same level of risk as the remaining patients with this treatment. For non- invasively treated patients five different categories of T- wave abnormality were significantly associated with an adverse outcome. Conclusion: New quantitative T- wave analysis of the admission ECG gives additional predictive information concerning clinical outcome and identifies patients who benefit from early coronary angiography.
Aims: To investigate the prognostic value of T- wave abnormalities in patients with non- ST- segment elevation acute coronary syndromes(NSTE- ACS), and whether such ECG changes may predict benefit from an early coronary angiography. Although ST- segment changes are considered the most important ECG feature in NSTE- ACS, T- wave abnormalities are the most common ECG finding. We hypothesize that a new quantitative approach to T- wave analysis could improve the prognostic value of this ECG abnormality. Methods and results: Quantitative T- wave analysis was performed on the admission ECG in 1609 patients with NSTE- ACS. Nine different categories of T- wave abnormality were analysed for their prognostic value concerning clinical outcome in patients not randomized to early coronary angiography. Also, the presence of one category(i.e. T- wave abnormality in >6 leads)was analysed for its predictive value concerning benefit from early coronary angiography. The combined study endpoint was death or myocardial infarction at 1 year follow- up. Patients with >6 leads with abnormal T waves and concomitant ST- segment depression had a higher risk when not receiving early coronary angiography(24 vs. 12% , respectively; P=0.003), but could be brought to the same level of risk as the remaining patients with this treatment. For non- invasively treated patients five different categories of T- wave abnormality were significantly associated with an adverse outcome. Conclusion: New quantitative T- wave analysis of the admission ECG gives additional predictive information concerning clinical outcome and identifies patients who benefit from early coronary angiography.
