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J Korean Soc Emerg Med > Volume 14(4); 2003 > Article
Journal of The Korean Society of Emergency Medicine 2003;14(4): 378-386.
Development and Prognosis of Non-Q Myocardial Infarction
In Han Song, Hwa Sik Song
Emergency Medical Department, Medical College of Dankook University, Chunan, Korea. sssong@dankook.ac.kr
In the prethrombolytic era, patients with non-Q myocardial infarction (non-MI) exhibited a lower short-term mortality, but were at higher risk for inhospital and long-term reinfarction, leading to a higher long-term mortality rate than for patients with Q MI. The objective of this study was to determine whether the incidence of non-Q MI among and the prognosis for patients with ST-segment elevation and thrombolytic therapy were different from those among patients who did not have thrombolytic therapy.
A retrospective chart review was done for 222 patients of acute myocardial infarction with ST-segment elevation The analysis compared the rate of transformation of ST-elevation to Q MI and non-Q MI and the clinical outcome (30-day mortality, reinfarction, recurrent angina, left ventricular (LV) dysfunction, and new congestive heart failure (CHF)) of patients who subsequently developed a Q or non-Q MI postthrombolysis to those for the controls.
The rate of non-Q MI was not significantly higher among patients receiving thrombolysis than among the control (31% vs 25%, p>0.1). Among patients receiving thrombolysis, the 30-day mortality (2.6% vs 0%), the inhospital reinfarction (10.3% vs 11.5%), and recurrent angina (20.6% vs 14.5%) were not significantly lower for those who developed a non-Q MI compared with either those who developed a Q MI or the control patients who developed non-Q MI, but left ventricular dysfunction (35.9% vs 55.2%) and new congestive heart failure (0 vs 10.3%) were significantly lower compared with those who developed Q MI.
Patients receiving thrombolysis do not necessarily develop a non-Q MI and do not have a better prognosis than those who either develop a postthrombolysis Q MI or a non-Q MI after no thrombolysis.
Key words: Myocardial infarction, Thrombolysis, Non-Q infarcts, Clinical outcome
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