Abstract:
AIMS:Previous analyses suggest only modest agreement between local site and core-laboratory (core-lab) electrocardiogram (ECG) interpretation in patients with acute coronary syndromes (ACSs); however, this has not been well examined outside of clinical trial populations. METHODS AND RESULTS:Patients (n = 5277 from 51 hospitals; 4916 with 1 year vital status) participating in the Canadian ACS Registry who were hospitalized with an ACS and had an interpretable initial ECG were included in this study. Core-lab ECG interpretation was blinded to site interpretation and outcomes. There was moderate agreement between site and core-lab regarding the predominant ECG findings (kappa = 0.49). Patients with core-lab-defined ST-elevation and cardiac marker elevation (n = 1202) not classified as ST-elevation by the site were less likely to receive acetylsalicylic acid (ASA) (90 vs. 96%, P < 0.0001), heparin (91 vs. 95%, P = 0.04), and reperfusion therapy (14 vs. 76%, P < 0.0001) than patients for whom there was agreement that ST-elevation was present. After adjusting for other validated prognostic factors, site-unrecognized ST-elevation was independently associated with higher mortality (odds ratio = 2.21; 95% CI, 1.46-3.36; P < 0.001). CONCLUSIONS:In patients with ACS, there was only moderate agreement between core-lab and site interpretation of the initial ECG. Site-unrecognized ST-elevation myocardial infarction was associated with underutilization of evidence-based therapies and increased 1-year mortality.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Vijayaraghavan R,Yan AT,Tan M,Fitchett DH,Georgescu AA,Hassan Q,Langer A,Goodman SG,Canadian Acute Coronary Syndromes Registry Investigators.doi
10.1093/eurheartj/ehm503subject
Has Abstractpub_date
2008-01-01 00:00:00pages
31-7issue
1eissn
0195-668Xissn
1522-9645pii
ehm503journal_volume
29pub_type
杂志文章,多中心研究abstract::We now have conclusive data that ACE inhibitors reduce mortality, morbidity, and symptoms in patients with low ejection fraction and/or heart failure. Therefore, ACE inhibitors should be routinely used in all such patients, as long as there are no clear contraindications. Routine use of ACE inhibitors will lead to pro...
journal_title:European heart journal
pub_type: 杂志文章,meta分析
doi:10.1093/eurheartj/15.suppl_b.9
更新日期:1994-05-01 00:00:00
abstract::This report describes a patient with left atrial ball thrombus which was detected during echocardiographic evaluation of combined mitral-aortic valve disease. Surgical correction was performed entirely on the basis of the echocardiographic diagnosis. ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060161
更新日期:1992-02-01 00:00:00
abstract::This study analyses the immediate outcome and the risk of recurrent restenosis in patients who, at the time of repeat coronary angioplasty for a first restenosis, had unstable (n = 50), 19%) or stable (n = 218, 81%) angina. Successful angioplasty was accomplished in 250 (93%) patients, 222 (89%) of whom had follow-up ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.2.235
更新日期:1993-02-01 00:00:00
abstract::The haemodynamic effects of intravenous frusemide (1 mg/kg) were studied in 22 male patients with left ventricular failure following acute myocardial infarction. Radiographic pulmonary oedema was present in all patients and their average left heart filling pressure was 20 mmHg. Bolus injection of the drug was followed...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061382
更新日期:1983-10-01 00:00:00
abstract::The efficacy and safety of catheter ablation of accessory pathways (AP) was studied in 79 children (age, 4-16 years), using DC shocks (n = 25) or radiofrequency energy (n = 54). All patients had documented arrhythmias including ventricular fibrillation in four. Organic heart disease was present in four patients. AP lo...
journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a060476
更新日期:1994-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehv497
更新日期:2016-01-07 00:00:00
abstract::To assess the value of exercise stress testing and of mental stress as predictors of hypertension, we studied 130 normotensive males 14-18 years of age. Sixty-five had at least one hypertensive parent (SHT), while 65 had normotensive parents (SNT). Systolic (SBP) and diastolic (DBP) blood pressure, rate-pressure produ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061894
更新日期:1985-06-01 00:00:00
abstract::Impaired relaxation of the ventricle has been described in hypertrophy and in ischemic heart disease. Some of these abnormalities are transient, but all occur at an early stage of the disease. The underlying mechanisms may vary depending on the etiology of the disease, and, except for ischemic heart disease, true myoc...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/4.suppl_a.43
更新日期:1983-01-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.3.391
更新日期:1993-03-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a014843
更新日期:1996-02-01 00:00:00
abstract::Twenty-nine men with chronic stable angina pectoris were investigated using stress electrocardiography (ECG) and stress transthoracic echocardiography by means of transoesophageal stimulation of the left atrium. At rest and after each stimulated frequency, ECG and 2-dimensional echocardiography combined with Doppler w...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.10.1344
更新日期:1993-10-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
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更新日期:2018-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/eurheartj/ehq013
更新日期:2010-03-01 00:00:00
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doi:10.1093/eurheartj/ehx809
更新日期:2018-06-21 00:00:00
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pub_type: 杂志文章
doi:10.1093/eurheartj/6.suppl_b.85
更新日期:1985-08-01 00:00:00
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pub_type: 杂志文章
doi:10.1093/eurheartj/8.suppl_d.33
更新日期:1987-08-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
doi:
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:2000-12-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1995-08-01 00:00:00
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更新日期:1995-12-01 00:00:00
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更新日期:2020-01-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2730
更新日期:2002-02-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm049
更新日期:2007-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2003-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:1996-05-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2014-06-01 00:00:00
abstract::The prognostic significance of angina pectoris and the effect of intervention with verapamil on the incidence of angina pectoris were studied in patients recovering from myocardial infarction and included in the Danish Verapamil Infarction Trial II. During the second week after admission patients were doubly-blindly r...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1994-02-01 00:00:00