A kórházi felvétel idején rögzített EKG jelentosége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában

A. Jánosi, Ofner Péter, Tomcsányi János, Müller Gábor, Hável Richárd, Soczó Asma Réka, Váradi Timea, Ferenci Tamás

Research output: Article

Abstract

Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocar-dial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95% confidence interval: 1.10-1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG.

Original languageHungarian
Pages (from-to)677-681
Number of pages5
JournalOrvosi Hetilap
Volume159
Issue number17
DOIs
Publication statusPublished - ápr. 1 2018

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Electrocardiography
Hospitalization
Myocardial Infarction
Bundle-Branch Block
Population
Percutaneous Coronary Intervention
Registries
Mortality
Blood Pressure
Morbidity
Proportional Hazards Models
Infarction
Creatinine
Databases
Confidence Intervals
Serum
ST Elevation Myocardial Infarction

Keywords

  • Left bundle branch block
  • Myocardiac infarction
  • Prognosis
  • Registry of myocardial infarction

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A kórházi felvétel idején rögzített EKG jelentosége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában. / Jánosi, A.; Péter, Ofner; János, Tomcsányi; Gábor, Müller; Richárd, Hável; Réka, Soczó Asma; Timea, Váradi; Tamás, Ferenci.

In: Orvosi Hetilap, Vol. 159, No. 17, 01.04.2018, p. 677-681.

Research output: Article

Jánosi, A. ; Péter, Ofner ; János, Tomcsányi ; Gábor, Müller ; Richárd, Hável ; Réka, Soczó Asma ; Timea, Váradi ; Tamás, Ferenci. / A kórházi felvétel idején rögzített EKG jelentosége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában. In: Orvosi Hetilap. 2018 ; Vol. 159, No. 17. pp. 677-681.
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title = "A k{\'o}rh{\'a}zi felv{\'e}tel idej{\'e}n r{\"o}gz{\'i}tett EKG jelentos{\'e}ge a sz{\'i}vinfarktus miatt kezelt betegek progn{\'o}zis{\'a}nak meghat{\'a}roz{\'a}s{\'a}ban",
abstract = "Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocar-dial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7{\%}). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4{\%} versus 12.4{\%}) and the 1-year period (47.3 versus 19.9{\%}). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95{\%} confidence interval: 1.10-1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG.",
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T1 - A kórházi felvétel idején rögzített EKG jelentosége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában

AU - Jánosi, A.

AU - Péter, Ofner

AU - János, Tomcsányi

AU - Gábor, Müller

AU - Richárd, Hável

AU - Réka, Soczó Asma

AU - Timea, Váradi

AU - Tamás, Ferenci

PY - 2018/4/1

Y1 - 2018/4/1

N2 - Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocar-dial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95% confidence interval: 1.10-1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG.

AB - Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocar-dial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95% confidence interval: 1.10-1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG.

KW - Left bundle branch block

KW - Myocardiac infarction

KW - Prognosis

KW - Registry of myocardial infarction

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