Apr 22, 2009

Unrecognized non-Q-wave myocardial infarction: prevalence and prognostic significance in patients with suspected coronary disease

PLoS Medicine
Han W KimRaymond J Kim

Abstract

Unrecognized myocardial infarction (UMI) is known to constitute a substantial portion of potentially lethal coronary heart disease. However, the diagnosis of UMI is based on the appearance of incidental Q-waves on 12-lead electrocardiography. Thus, the syndrome of non-Q-wave UMI has not been investigated. Delayed-enhancement cardiovascular magnetic resonance (DE-CMR) can identify MI, even when small, subendocardial, or without associated Q-waves. The aim of this study was to investigate the prevalence and prognosis associated with non-Q-wave UMI identified by DE-CMR. We conducted a prospective study of 185 patients with suspected coronary disease and without history of clinical myocardial infarction who were scheduled for invasive coronary angiography. Q-wave UMI was determined by electrocardiography (Minnesota Code). Non-Q-wave UMI was identified by DE-CMR in the absence of electrocardiographic Q-waves. Patients were followed to determine the prognostic significance of non-Q-wave UMI. The primary endpoint was all-cause mortality. The prevalence of non-Q-wave UMI was 27% (50/185), compared with 8% (15/185) for Q-wave UMI. Patients with non-Q-wave UMI were older, were more likely to have diabetes, and had higher Framingham risk ...Continue Reading

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Citations

Mentioned in this Paper

Trichohepatoenteric Syndrome
Aspects of Radionuclide Imaging
Troponin
Coronary Artery Disease
Entire Left Bundle Branch
Plain X-ray
Myocardium
Atypical Angina
Myocardial Infarction
Hypercholesterolemia

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