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Late potentials and ejection fraction at hospital discharge: prognostic value in thrombolyzed and non-thrombolyzed patients: a preliminary report

(1991) ACTA CARDIOLOGICA. 46(5). p.531-541
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Abstract
The prognostic value of the use of thrombolytic therapy (TL), the ejection fraction (EF) and the presence of late potentials (LP) in the signal-averaged ECG (filter < 40 Hz) at the time of hospital discharge was assessed in a multicenter prospective study. This report presents the follow-up at 4 months of the first 263 patients. Thrombolytic therapy was given to 41%. The mean ejection fraction was 45%. The average duration of the high frequency QRS complex (HFQRS) was 104 ms. The mean duration of the terminal signal under 40-mu-V (D40) was 31 ms. The combination of both HFQRS > 110 ms and a D40 > 40 ms was considered as presence of LP. The cardiac mortality at 4 months was 5.7% (15 patients). Late ventricular tachycardia or fibrillation occurred in 2.3% (6 patients). The relative risk (RR) for cardiac death or late events was 5.14 with a 95% confidence interval (CI) of 1.2 to 22.0 when no thrombolytic therapy was used. The RR was 3.39 (CI:1.4 to 8.4) for patients with an EF lower than 30%. The single most important electrocardiographic parameter was a D40 > 40 ms (RR:3.14, CI:1.3 to 7.8). The presence of LP had a RR of 4.28 (CI:1.7 to 10.5). With stepwise regression analysis it was evident that cardiac function and information obtained by signal averaging offered independent prognostic information. The presence of LP at hospital discharge after acute infarction offers additional prognostic information to EF for the risk of later cardiac death, especially in patients without thrombolysis.
Keywords
THROMBOLYTIC THERAPY, RISK STRATIFICATION, MYOCARDIAL INFARCTION, LATE POTENTIALS

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Chicago
Jordaens, Luc, P Schoenfeld, C Demeester, P Bethume, C Mahieu, and P Block. 1991. “Late Potentials and Ejection Fraction at Hospital Discharge: Prognostic Value in Thrombolyzed and Non-thrombolyzed Patients: a Preliminary Report.” Acta Cardiologica 46 (5): 531–541.
APA
Jordaens, L., Schoenfeld, P., Demeester, C., Bethume, P., Mahieu, C., & Block, P. (1991). Late potentials and ejection fraction at hospital discharge: prognostic value in thrombolyzed and non-thrombolyzed patients: a preliminary report. ACTA CARDIOLOGICA, 46(5), 531–541.
Vancouver
1.
Jordaens L, Schoenfeld P, Demeester C, Bethume P, Mahieu C, Block P. Late potentials and ejection fraction at hospital discharge: prognostic value in thrombolyzed and non-thrombolyzed patients: a preliminary report. ACTA CARDIOLOGICA. 1991;46(5):531–41.
MLA
Jordaens, Luc, P Schoenfeld, C Demeester, et al. “Late Potentials and Ejection Fraction at Hospital Discharge: Prognostic Value in Thrombolyzed and Non-thrombolyzed Patients: a Preliminary Report.” ACTA CARDIOLOGICA 46.5 (1991): 531–541. Print.
@article{8118966,
  abstract     = {The prognostic value of the use of thrombolytic therapy (TL), the ejection fraction (EF) and the presence of late potentials (LP) in the signal-averaged ECG (filter {\textlangle} 40 Hz) at the time of hospital discharge was assessed in a multicenter prospective study. This report presents the follow-up at 4 months of the first 263 patients. Thrombolytic therapy was given to 41\%. The mean ejection fraction was 45\%. The average duration of the high frequency QRS complex (HFQRS) was 104 ms. The mean duration of the terminal signal under 40-mu-V (D40) was 31 ms. The combination of both HFQRS {\textrangle} 110 ms and a D40 {\textrangle} 40 ms was considered as presence of LP. The cardiac mortality at 4 months was 5.7\% (15 patients). Late ventricular tachycardia or fibrillation occurred in 2.3\% (6 patients). The relative risk (RR) for cardiac death or late events was 5.14 with a 95\% confidence interval (CI) of 1.2 to 22.0 when no thrombolytic therapy was used. The RR was 3.39 (CI:1.4 to 8.4) for patients with an EF lower than 30\%. The single most important electrocardiographic parameter was a D40 {\textrangle} 40 ms (RR:3.14, CI:1.3 to 7.8). The presence of LP had a RR of 4.28 (CI:1.7 to 10.5). With stepwise regression analysis it was evident that cardiac function and information obtained by signal averaging offered independent prognostic information. The presence of LP at hospital discharge after acute infarction offers additional prognostic information to EF for the risk of later cardiac death, especially in patients without thrombolysis.},
  author       = {Jordaens, Luc and Schoenfeld, P and Demeester, C and Bethume, P and Mahieu, C and Block, P},
  issn         = {0001-5385},
  journal      = {ACTA CARDIOLOGICA},
  language     = {eng},
  number       = {5},
  pages        = {531--541},
  title        = {Late potentials and ejection fraction at hospital discharge: prognostic value in thrombolyzed and non-thrombolyzed patients: a preliminary report},
  volume       = {46},
  year         = {1991},
}