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Baseline Q waves as...
Baseline Q waves as a prognostic modulator in patients with ST-segment elevation : insights from the PLATO trial
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Siha, Hany (författare)
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Das, Debraj (författare)
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Fu, Yuling (författare)
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Zheng, Yinggan (författare)
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Westerhout, Cynthia M. (författare)
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Storey, Robert F. (författare)
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- James, Stefan K., 1964- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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- Wallentin, Lars, 1943- (författare)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR)
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Armstrong, Paul W. (författare)
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(creator_code:org_t)
- 2012-04-30
- 2012
- Engelska.
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Ingår i: CMJA. Canadian Medical Association Journal. Onlineutg. Med tittel. - : CMA Joule Inc.. - 0820-3946 .- 1488-2329. ; 184:10, s. 1135-1142
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https://www.cmaj.ca/...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Background: Baseline Q waves may provide additional value compared with time from the onset of symptoms in predicting outcomes for patients with ST-segment elevation. We evaluated whether baseline Q waves superseded time from symptom onset as a prognostic marker of one-year mortality in patients with ST-segment elevation acute coronary syndrome. Our study was derived from data from patients undergoing primary percutaneous coronary intervention within 24 hours in the PLATelet inhibition and patient Outcomes trialMethods: Q waves on the baseline electrocardiogram were evaluated by a blinded core laboratory. We assessed the associations between baseline Q waves and time from symptom onset to percutaneous coronary intervention with peak biomarkers, ST-segment resolution on the discharge electrocardiogram, and one-year all-cause and vascular mortality.Results: Of 4341 patients with ST-segment elevation, 46% had baseline Q waves. Compared to those without Q waves, those with baseline Q waves were older, more frequently male, had higher heart rates, more advanced Killip class and had a longer time between the onset of symptoms and percutaneous coronary intervention. They also had higher one-year all-cause mortality than patients without baseline Q waves (baseline Q waves: 4.9%; no baseline Q waves: 2.8%; hazard ratio [HR] 1.78, 95% confidence interval [CI] 1.29-2.45, p < 0.001). Complete ST-segment resolution was greatest and all-cause mortality lowest among those with symptom onset three hours or less before percutaneous coronary intervention and no baseline Q waves. After multivariable adjustment, baseline Q waves, but not time from symptom onset, were associated with a significant increase in all-cause mortality (adjusted HR 1.42, 95% CI 1.10-2.01, p = 0.046) and vascular mortality (adjusted HR 1.58, 95% CI 1.09-2.28, p = 0.02).Interpretation: The presence of baseline Q waves provides useful additional prognostic insight into the clinical outcome of patients with ST-segment elevation. Clinical Trials. gov registration no. NCT00391872
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Siha, Hany
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Das, Debraj
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Fu, Yuling
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Zheng, Yinggan
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Westerhout, Cynt ...
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Storey, Robert F ...
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visa fler...
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James, Stefan K. ...
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Wallentin, Lars, ...
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Armstrong, Paul ...
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CMJA. Canadian M ...
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Uppsala universitet