Electrocardiographic predictors of poor outcome in acute myocardial infarction

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dc.contributor.advisorChin, Ashley
dc.contributor.advisorViljoen, Charle
dc.contributor.advisorHitzeroth, Jens
dc.contributor.advisorHoevelman, Julian
dc.contributor.authorShirley, Samantha Shirley
dc.date.accessioned2025-04-03T10:18:30Z
dc.date.available2025-04-03T10:18:30Z
dc.date.issued2024
dc.date.updated2025-04-03T08:57:08Z
dc.description.abstractIntroduction: Myocardial infarction (MI) is a major cause of death worldwide. An ECG is indicated in all patients with suspected MI. The aim of this study was to evaluate electrocardiographic predictors of outcome in acute coronary syndrome (ACS). Methods: We analyzed 12-lead ECGs of 301 consecutive patients admitted to the coronary care unit (CCU) at a tertiary centre during 2016 with a diagnosis of ACS. ECGs were done on admission, and after that daily throughout the hospitalisation. Poor outcome was defined as all-cause mortality within a three-year period after the index MI. Results: This cohort of 301 patients (42.2% female) with a mean age of 57.4±11.9 years, presented with either ST-elevation myocardial infarction (STEMI, 57.5%) or non-ST elevation myocardial infarction (NSTEMI, 42.5%). Fifty-one (16.9%) patients died within three years after their index presentation. Multivariable regression analyses revealed that left atrial enlargement (LAE, odds ratio [OR] 3.91 [95% confidence interval [CI] 1.39-11.02], p=0.010) and ST depression (OR 3.64 [95% CI 1.33-9.93], p=0.012) were predictive of poor outcome, wheras sinus rhythm with normal rate was associated with a better prognosis (OR 0.33 [95% CI 0.12- 0.91] p=0.032). Patients with two or more risk factors (i.e., LAE, ST depression, sinus tachycardia) experienced higher mortality rates (p<0.001).Conclusion: Our study showed that the ECG has prognostic value in patients presenting with acute MI. ECG features that were independently associated with increased mortality within the first three years of MI (LAE, ST depression and/or sinus tachycardia) could assist with risk stratification of patients presenting with ACS.
dc.identifier.apacitationShirley, S. S. (2024). <i>Electrocardiographic predictors of poor outcome in acute myocardial infarction</i>. (). University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/41338en_ZA
dc.identifier.chicagocitationShirley, Samantha Shirley. <i>"Electrocardiographic predictors of poor outcome in acute myocardial infarction."</i> ., University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2024. http://hdl.handle.net/11427/41338en_ZA
dc.identifier.citationShirley, S.S. 2024. Electrocardiographic predictors of poor outcome in acute myocardial infarction. . University of Cape Town ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/41338en_ZA
dc.identifier.ris TY - Thesis / Dissertation AU - Shirley, Samantha Shirley AB - Introduction: Myocardial infarction (MI) is a major cause of death worldwide. An ECG is indicated in all patients with suspected MI. The aim of this study was to evaluate electrocardiographic predictors of outcome in acute coronary syndrome (ACS). Methods: We analyzed 12-lead ECGs of 301 consecutive patients admitted to the coronary care unit (CCU) at a tertiary centre during 2016 with a diagnosis of ACS. ECGs were done on admission, and after that daily throughout the hospitalisation. Poor outcome was defined as all-cause mortality within a three-year period after the index MI. Results: This cohort of 301 patients (42.2% female) with a mean age of 57.4±11.9 years, presented with either ST-elevation myocardial infarction (STEMI, 57.5%) or non-ST elevation myocardial infarction (NSTEMI, 42.5%). Fifty-one (16.9%) patients died within three years after their index presentation. Multivariable regression analyses revealed that left atrial enlargement (LAE, odds ratio [OR] 3.91 [95% confidence interval [CI] 1.39-11.02], p=0.010) and ST depression (OR 3.64 [95% CI 1.33-9.93], p=0.012) were predictive of poor outcome, wheras sinus rhythm with normal rate was associated with a better prognosis (OR 0.33 [95% CI 0.12- 0.91] p=0.032). Patients with two or more risk factors (i.e., LAE, ST depression, sinus tachycardia) experienced higher mortality rates (p<0.001).Conclusion: Our study showed that the ECG has prognostic value in patients presenting with acute MI. ECG features that were independently associated with increased mortality within the first three years of MI (LAE, ST depression and/or sinus tachycardia) could assist with risk stratification of patients presenting with ACS. DA - 2024 DB - OpenUCT DP - University of Cape Town KW - acute coronary syndrome KW - arrhythmias KW - ECG KW - myocardial infarction KW - mortality. LK - https://open.uct.ac.za PB - University of Cape Town PY - 2024 T1 - Electrocardiographic predictors of poor outcome in acute myocardial infarction TI - Electrocardiographic predictors of poor outcome in acute myocardial infarction UR - http://hdl.handle.net/11427/41338 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/41338
dc.identifier.vancouvercitationShirley SS. Electrocardiographic predictors of poor outcome in acute myocardial infarction. []. University of Cape Town ,Faculty of Health Sciences ,Department of Medicine, 2024 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/41338en_ZA
dc.language.isoen
dc.language.rfc3066eng
dc.publisher.departmentDepartment of Medicine
dc.publisher.facultyFaculty of Health Sciences
dc.publisher.institutionUniversity of Cape Town
dc.subjectacute coronary syndrome
dc.subjectarrhythmias
dc.subjectECG
dc.subjectmyocardial infarction
dc.subjectmortality.
dc.titleElectrocardiographic predictors of poor outcome in acute myocardial infarction
dc.typeThesis / Dissertation
dc.type.qualificationlevelMasters
dc.type.qualificationlevelMMed
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