Long-term prognosis after acute myocardial infarction in patients with left ventricular hypertrophy on the electrocardiogram

Solomon Behar, Henrietta Reicher-Reiss, Edward Abinader, Jacob Agmon, Jacob Barzilai, Yaacov Friedman, Elieser Kaplinsky, Nissim Kauli, Yehezkiel Kishon, Abraham Palant, Benyamin Peled, Leonardo Reisin, Zwi Schlesinger, Izhar Zahavi, Monty Zion, Uri Goldbourt

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

Abstract

Among 4,720 consecutive hospital survivors from acute myocardial infarction (AMI) treated in 13 coronary care units between July 1981 and August 1983, the estimated prevalence of electrocardiographic left ventricular (LV) hypertrophy was 6.1%. The prevalence of electrocardiographs LV hypertrophy increased with age and was higher in patients with previous myocardial infarction, angina and systemic hypertension. Mean age of patients with electrocardiographic LV hypertrophy was 67.2 vs 61.4 years in counterparts free of electrocardiographic LV hypertrophy. Patients with electrocardiographic LV hypertrophy had a higher rate of congestive heart failure on admission, or developing during their stay in coronary care units. The 1- and 5-year mortality rates were 19.7 and 46.6% among patients with electrocardiographic LV hypertrophy versus 8.7 and 26.2%, respectively (p <0.001) in patients without this finding. The covariate-adjusted odds ratio of 1-year mortality was 1.88 for the presence of electrocardiographic LV hypertrophy when age alone was adjusted for, and 1.51 (90% confidence interval, 1.09 to 2.10) when multiple covariate adjustment was undertaken. After multiple covariate adjustment for 5-year mortality after discharge, the relative risk associated with electrocardiographic LV hypertrophy was 1.51 (90% confidence interval, 1.26 to 1.80). The results of the present study showed that the presence of electrocardiographic LV hypertrophy on the discharge electrocardiogram of survivors from AMI is associated with a 1.5-fold increase of short- and long-term mortality. Patients with electrocardiographic LV hypertrophy, potentially at an increased post-discharge risk, may be candidates for early noninvasive testing and more intensive follow-up after recovering from AMI.

Original languageEnglish
Pages (from-to)985-990
Number of pages6
JournalAmerican Journal of Cardiology
Volume69
Issue number12
DOIs
StatePublished - 15 Apr 1992
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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