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Bedside risk stratification after acute myocardial infarction: Prospective evaluation of the use of heart rate and left ventricular function

2005; Elsevier BV; Volume: 38; Issue: 2 Linguagem: Inglês

10.1016/j.jelectrocard.2004.10.009

1532-8430

Oliver Mauß, Thomas Klingenheben, Paweł Ptaszyński, Stefan H. Hohnloser,

Cardiac electrophysiology and arrhythmias

This study evaluated the predictive power of heart rate (HR) assessed from the standard 12-lead electrocardiogram (ECG) or from Holter recordings for future mortality and arrhythmic events in survivors of acute myocardial infarction (AMI). Data from 432 consecutive survivors of AMI (343 men, 89 women; mean [SD] age, 58 [11] years) were analyzed. Heart rate was assessed from a standard 12-lead ECG and from 24-hour Holter recordings obtained at hospital discharge. In addition, left ventricular ejection fraction (LVEF) was noninvasively determined. The study end point was prospectively defined as a composite end point comprising mortality and arrhythmic events (ie, sudden death, resuscitated ventricular fibrillation, sustained ventricular tachycardia). Patients were followed for an average (SD) of 41 (25) months. Patient age, LVEF, and HR were univariate risk predictors of event-free survival. Multivariate analysis by means of a stepwise regression analysis revealed LVEF (χ2 11.4, P = .0007), age (χ2 9.2, P = .02), and HR assessed from the standard 12-lead ECG (χ2 7.1, P = .008) as independent risk parameters. Bedside risk stratification of survivors of AMI is feasible using simple parameters such as age, LVEF, and HR.