Abstract:
:The prognosis for patients with non-Q-wave myocardial infarction (MI) remains controversial, although a number of studies have shown a less favorable outlook after hospital discharge for patients with non-Q-wave than for those with Q-wave infarction. Numerous management strategies are available to the clinician, many of which involve an interventional strategy (myocardial revascularization with coronary bypass surgery or angioplasty) or a more conservative approach which emphasizes secondary prevention with medical therapy. This review summarizes the role of identifying risk variables in patients with non-Q-wave MI and their importance to clinical decision making. Based on data obtained from the Diltiazem Reinfarction Study (DRS), it has been shown that 20% of patients experience one or more episodes of spontaneous postinfarction angina which is associated with a significant increased (33%) 2-week mortality and an appreciable fivefold increased incidence of early reinfarction compared to patients without early recurrent ischemia. Similar findings have been observed in this same cohort of patients who were followed for one year, in that there was twofold higher incidence of death and late reinfarction at one year of follow-up. Other risk factors also appear to be important determinants of adverse long-term outcome after non-Q-wave MI and include persistent ST segment depression on serial electrocardiograms, congestive heart failure, and left ventricular hypertrophy. Medical therapy employed for secondary prophylaxis after non-Q-wave MI has failed to show a convincing therapeutic rationale for beta blocker administration. In contrast, diltiazem has been shown to influence the early and late outcome following non-Q-wave MI favorably.(ABSTRACT TRUNCATED AT 250 WORDS)
journal_name
Clin Cardioljournal_title
Clinical cardiologyauthors
Boden WEsubject
Has Abstractpub_date
1989-07-01 00:00:00pages
III33-40issue
7 Suppl 3eissn
0160-9289issn
1932-8737journal_volume
12pub_type
杂志文章,评审abstract::This study analyzes the prevalence of coronary artery disease (CAD) among patients with rheumatic valvular heart disease (VHD) in Chile. Coronary angiography was performed in all patients referred to cardiac catheterization with VHD who were over age 50 years and who had angina or ECG signs of ischemia. A total of 100...
journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960060709
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pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:Clinical cardiology
pub_type: 杂志文章
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journal_title:Clinical cardiology
pub_type: 杂志文章,评审
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pub_type: 临床试验,杂志文章,评审
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更新日期:2000-10-01 00:00:00
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journal_title:Clinical cardiology
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更新日期:2009-01-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1995-09-01 00:00:00
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pub_type: 杂志文章,评审
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journal_title:Clinical cardiology
pub_type: 杂志文章
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更新日期:1989-08-01 00:00:00
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journal_title:Clinical cardiology
pub_type: 杂志文章
doi:10.1002/clc.4960120905
更新日期:1989-09-01 00:00:00
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