74356
document
Clinical significance and prognostic importance of left ventricular hypertrophy in non-Q-wave acute myocardial infarction . Left ventricular ( LV ) hypertrophy is known to be an independent risk factor for cardiac death , but its significance in non-Q-wave acute myocardial infarction ( AMI ) has not been assessed previously . In a randomized diltiazem-placebo-controlled therapeutic trial of non-Q-wave AMI confirmed by creatine kinase-MB ( CK-MB ) , 126 of 544 patients ( 23 % ) exhibited LV hypertrophy using standard voltage criteria . Compared to patients without LV hypertrophy , patients with LV hypertrophy were significantly older ( 65 vs 60 years , p less than 0.0001 ) and had smaller peak adjusted CK levels ( 490 +/- 376 vs 666 +/- 726 IU/liter , p less than 0.001 ) than patients without LV hypertrophy . Patients with and without LV hypertrophy did not differ significantly in acute mortality during hospitalization , progression to Q waves , reinfarction by CK-MB criteria or angina associated with transient electrocardiographic changes . Compared with patients without LV hypertrophy , those patients with non-Q-wave AMI and LV hypertrophy had a 2-fold higher incidence of reinfarction ( 24 vs 12 % , p less than 0.005 ) and death ( 19 vs 9 % , p = 0.044 ) during the first year of follow-up . Multivariate regression analysis revealed that the relative risk of death and reinfarction during the initial year after AMI was increased by a factor of 1.7 and 2.1 among patients with LV hypertrophy , respectively . It was therefore concluded that , although patients with LV hypertrophy and non-Q-wave AMI have smaller enzymatic infarcts and the same short-term prognosis as do patients without LV hypertrophy , their reinfarction and mortality rates are significantly increased during the first year of follow-up . ( ABSTRACT TRUNCATED AT 250 WORDS )
74357
Intervention_Control
diltiazem-placebo-controlled
74358
Outcome_Mortality
mortality
74359
Outcome_Other
hospitalization
74360
Outcome_Physical
progression to Q waves
74361
Outcome_Physical
reinfarction by CK-MB criteria
74362
Outcome_Physical
angina
74363
Outcome_Physical
reinfarction
74364
Outcome_Mortality
risk of death
74365
Outcome_Physical
reinfarction
74366
Participant_Condition
non-Q-wave acute myocardial infarction
74367
Participant_Condition
non-Q-wave acute myocardial infarction ( AMI )