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Are electrocardiogr...
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Svedjeholm, RolfÖstergötlands Läns Landsting,Kardiologiska kliniken
(författare)
Are electrocardiographic Q-wave criteria reliable for diagnosis of perioperative myocardial infarction after coronary surgery?
- Artikel/kapitelEngelska1998
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LIBRIS-ID:oai:DiVA.org:liu-81054
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https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-81054URI
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https://doi.org/10.1016/S1010-7940(98)00091-8DOI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:art swepub-publicationtype
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Objective: A major assumption in cardiovascular medicine is that Q-waves on the electrocardiogram indicate major myocardial tissue damage. The appearance of a new Q-wave has therefore been considered the most reliable criterion for diagnosis of perioperative myocardial infarction (PMI) in cardiac surgery. In a study, originally intended to evaluate troponin-T as a marker of PMI, analysis of our data aroused the need to address the reliability of Q-wave criteria for diagnosis of PMI.Methods: In 302 consecutive patients undergoing coronary surgery, Q-wave and other electrocardiogram (ECG) criteria were compared with biochemical markers of myocardial injury and the postoperative course. All ECGs were analysed by a cardiologist blinded to the biochemical analyses and the clinical course.Results: The incidence of positive Q-wave criteria was 8.1%. Combined biochemical (CK-MB≥70 μg/l) and Q-wave criteria were found in 1.0%. Patients with new Q-waves did not have CK-MB or troponin-T levels significantly different from those without Q-waves. More than 25% of the Q-waves were associated with plasma troponin-T below the reference level (<0.2 μg/l) on the fourth postoperative day. Q-wave criteria alone did not influence the postoperative course. In contrast, biochemical markers correlated with clinical outcome.Conclusions: The majority of Q-waves appearing after coronary surgery were not associated with major myocardial tissue damage, and according to troponin-T one-fourth of the Q-waves were not associated with myocardial necrosis. Furthermore, the appearance of Q-waves had little influence on short term clinical outcome. Therefore, the use of Q-wave criteria as the gold standard for diagnosis of PMI may have to be questioned.
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Biuppslag (personer, institutioner, konferenser, titlar ...)
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Dahlin, Lars-GöranÖstergötlands Läns Landsting,Kardiologiska kliniken(Swepub:liu)larda18
(författare)
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Lundberg, ClaesÖstergötlands Läns Landsting,Kardiologiska kliniken
(författare)
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Szabo, ZoltanDepartment of Cardiothoracic Surgery, Debrecen, Hungary
(författare)
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Kågedal, BertilLinköpings universitet,Klinisk kemi,Hälsouniversitetet(Swepub:liu)berka70
(författare)
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Nylander, EvaÖstergötlands Läns Landsting,Fysiologiska kliniken(Swepub:liu)evany41
(författare)
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Olin, ChristianÖstergötlands Läns Landsting,Kardiologiska kliniken
(författare)
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Rutberg, HansÖstergötlands Läns Landsting,Kardiologiska kliniken
(författare)
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Östergötlands Läns LandstingKardiologiska kliniken
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:European Journal of Cardio-Thoracic Surgery13:6, s. 655-6611010-79401873-734X
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