Prognostic predictive values of the initial electrocardiogram with ST-segment elevation acute myocardial infarction in Chinese patients ST

Objective: To study the electrocardiogram (ECG) features that predict 30-day mortality of ST-segment elevation acute myocardial infarction (STEMI) in Chinese patients. Method: This was a retrospective study. Patients presenting within twelve hours after the onset of chest pain with ECG features compatible with STEMI and the diagnosis confirmed after admission were included in the study. Data taken into account included age, sex and thrombolytic therapy in the emergency department. The hospital records of the patients were later retrieved from the computer. The initial ECG performed in the emergency department were reviewed. Results: A total of 98 patients were included in the study. There was no statistically significant relationship between 30-day mortality and the type of myocardial infarction or the magnitude of the ST segment changes. Distortion of the terminal portion of the QRS complex and prior evidence of myocardial infarction (in another location different from the presenting one) showed statistically significant relationship with 30-day mortality, with odds ratio 10.364 (95% CI 1.715-62.620) and 12.731 (95% CI 2.31769.962) respectively. Conclusion: In newly diagnosed STEMI patients, if there is evidence of terminal distortion of the QRS complex or prior ECG changes of myocardial infarction, the 30-day mortality will be significantly higher. (Hong Kong j.emerg.med. 2006;13:79-83)