ST-segment abnormalities are associated with long-term prognosis in non-ST-segment elevation acute coronary syndromes: The ERICO-ECG study

• Published in: Journal of electrocardiology 2016-05, Vol.49 (3), p.411-416
• Main Authors: Brandão, Rodrigo M., MD, PhD, Samesima, Nelson, MD, PhD, Pastore, Carlos A., MD, PhD, Staniak, Henrique L., MD, PhD, Lotufo, Paulo A., MD, PhD, Bensenor, Isabela M., MD, PhD, Goulart, Alessandra C., MD, PhD, Santos, Itamar S., MD, PhD
• Format: Article
• Language: English
• Subjects: Acute Coronary Syndrome - diagnosis; Acute Coronary Syndrome - mortality; Acute Coronary Syndrome - therapy; Aged; Algorithms; Brazil - epidemiology; Cardiovascular; Cohort; Cohort Studies; Comorbidity; Coronary heart disease; Diagnosis, Computer-Assisted - methods; Electrocardiography; Electrocardiography - methods; Electrocardiography - statistics & numerical data; Female; Hospitalization - statistics & numerical data; Humans; Longitudinal Studies; Male; Middle Aged; Non-ST Elevated Myocardial Infarction - diagnosis; Non-ST Elevated Myocardial Infarction - mortality; Non-ST Elevated Myocardial Infarction - therapy; Prevalence; Prognosis; Proportional Hazards Models; Reproducibility of Results; Risk Assessment - methods; Sensitivity and Specificity; Survival Analysis
• ISSN: 0022-0736; 1532-8430
• DOI: 10.1016/j.jelectrocard.2016.01.005

Abstract Introduction We aimed to identify whether ST-segment abnormalities, in the admission or during in-hospital stay, are associated with survival and/or new incident myocardial infarction (MI) in 623 non-ST-elevation acute coronary syndrome participants of the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. Materials and methods ERICO is conducted in a community-based hospital. ST-segment analysis was based on the Minnesota Code. We built Cox regression models to study whether ECG was an independent predictor for clinical outcomes. Results Median follow-up was 3 years. We found higher risk of death due to MI in individuals with ST-segment abnormalities in the final ECG (adjusted hazard ratio: 2.68; 95% confidence interval: 1.14–6.28). Individuals with ST-segment abnormalities in any tracing had a non-significant trend toward a higher risk of fatal or new non-fatal MI (p = 0.088). Conclusions ST-segment abnormalities after the initial tracing added long-term prognostic information.