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

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 3years. 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.

[1]  P. Lotufo.  Cardiovascular diseases in Brazil: premature mortality, risk factors and priorities for action. Comments on the preliminary results from the Brazilian National Health Survey (PNS), 2013. , 2015, Sao Paulo medical journal = Revista paulista de medicina.

[2]  R. Califf,et al.  Prognostic value of the admission electrocardiogram in acute coronary syndromes. , 1999, JAMA.

[3]  A. Yan,et al.  ST-segment depression in non-ST elevation acute coronary syndromes: quantitative analysis may not provide incremental prognostic value beyond comprehensive risk stratification. , 2006, American heart journal.

[4]  Nobhojit Roy,et al.  Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990–2013: quantifying the epidemiological transition , 2015, The Lancet.

[5]  Bernadette A. Thomas,et al.  Global, regional, and national age–sex specific all-cause and cause-specific mortality for 240 causes of death, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, The Lancet.

[6]  Dan J Stein,et al.  Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, The Lancet.

[7]  David Brieger,et al.  Comparative prognostic value of T-wave inversion and ST-segment depression on the admission electrocardiogram in non-ST-segment elevation acute coronary syndromes. , 2013, American heart journal.

[8]  I. Benseñor,et al.  Design and baseline characteristics of a coronary heart disease prospective cohort: two-year experience from the strategy of registry of acute coronary syndrome study (ERICO study) , 2013, Clinics.

[9]  E. Simonson,et al.  The Electrocardiogram in Population Studies: A Classification System , 1960, Circulation.

[10]  P. Armstrong,et al.  Quantitative ST-depression in acute coronary syndromes: the PLATO electrocardiographic substudy. , 2013, The American journal of medicine.

[11]  I. Benseñor,et al.  One-year Mortality after an Acute Coronary Event and its Clinical Predictors: The ERICO Study , 2015, Arquivos brasileiros de cardiologia.

[12]  S. Pocock,et al.  Usefulness of the admission electrocardiogram to predict long-term outcomes after non-ST-elevation acute coronary syndrome (from the FRISC II, ICTUS, and RITA-3 [FIR] Trials). , 2012, The American journal of cardiology.

[13]  H. White,et al.  Prognostic utility of quantifying evolutionary ST-segment depression on early follow-up electrocardiogram in patients with non-ST-segment elevation acute coronary syndromes. , 2010, European heart journal.

[14]  C. Cannon,et al.  The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q wave myocardial infarction: results of the TIMI III Registry ECG Ancillary Study. Thrombolysis in Myocardial Ischemia. , 1997, Journal of the American College of Cardiology.