Prognostic Value of Standard Electrocardiographic Parameters for Predicting Major Adverse Cardiac Events after Acute Myocardial Infarction

Methods: Between January 2006 and January 2008, 529 AMI patients were included. ECG variables were analyzed from the ECG taken on discharge day. The 1-year MACEs were defined as death, nonfatal MI, and revascularization including repeat percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). Mean follow-up duration was 360 +/- 119 days. Results: Of these patients, 497 (94%) patients provided complete follow-up data (355 males; 67 +/- 12 years old). The rate of 1-year MACEs was 16%. In univariate analysis, heart rate, corrected QT interval, left ventricular (LV) hypertrophy, voltage (SV1 + RV5), lateral ST-depression (V5-6 or I, aVL), pathologic Q wave (V1-4, V5-6), ST-elevation (V1-4, V5-6 or I, aVL), and T-wave inversion (V1-4, V5-6, or I, aVL) had a significant association with 1-year MACEs. In the Cox regression hazard model, lateral ST-depression (hazard ratio [HR] 2.260, 95% confidence interval [CI] 1.204 to 4.241, P = 0.011) and corrected QT interval (HR 1.007, 95% CI 1.002 to 1.011, P = 0.004) were independent predictors of 1-year MACEs. After adjustment for all risk variables, lateral ST-depression (HR 3.781, 95% CI 1.047 to 13.656, P = 0.042) was the only ECG variable that independently predicted 1-year MACEs. Conclusion: Lateral ST-depression on discharge day ECG is an independent predictor of 1-year MACEs after AMI. Ann Noninvasive Electrocardiol 2011;16(1):56-63.