Q Waves at Presentation in Patients With ST-Segment–Elevation Myocardial Infarction
An Underappreciated Marker of Risk
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The degree of myocardial salvageability and the management of patients with ST-segment–elevation myocardial infarction (STEMI) is time sensitive; thus, clinicians must use readily available data to glean prognostic information and to guide clinical decisions. ECGs, the backbone of STEMI diagnosis, are rapidly obtained and contain a wealth of prognostic data. Data from clinical trial databases of patients with STEMI have shown that the presence of Q waves is associated with adverse cardiovascular outcomes, including higher mortality.1–3 Moreover, the prognostic significance of Q waves has been shown to exceed that of time since symptom onset, the variable most often used to assess the suitability of reperfusion therapy related to the time course of infarction.2 However, this relationship between Q waves on baseline ECG for STEMI patients and adverse cardiovascular outcomes has not been described in unselected patient populations treated in routine clinical practice.
See Article by Zheng et al
In this issue of Circulation: Cardiovascular Interventions, Zheng et al4 sought to quantify this relationship in a registry of consecutive STEMI patients admitted to 5 hospitals in Edmonton, Canada. There were 3593 STEMI patients admitted from 2006 to 2011; after exclusions, …