Fox J P, Beattie J M, Salih M S, Davies M K, Littler W A, Murray R G
Department of Cardiovascular Medicine, University of Birmingham, East Birmingham Hospital.
Br Heart J. 1990 Mar;63(3):151-3. doi: 10.1136/hrt.63.3.151.
The exercise test characteristics, coronary anatomy, and prognosis of patients discharged after non Q wave myocardial infarction were compared with those in whom Q wave infarction occurred. Of the 339 patients studied, all of whom were less than or equal to 70 years, 87 (26%) had had a non Q wave infarction. There were no significant differences in the exercise test characteristics between the two groups, and in those 149 patients in whom angiography was performed triple vessel disease was present in 36/114 (32%) of the Q wave group and 9/35 (26%) of the non Q wave group. The infarct related artery was more often patent in the non Q wave group (27/35 (77%] than in the Q wave group (53/114 (46%]. The one year mortality and the reinfarction and angina rates were similar in the two groups and the exercise test remained a good discriminator for predicting patients at risk of future cardiac events in both groups. In view of the similar outcome and severity of coronary disease in those aged less than or equal to 70 with non Q wave infarcts, the distinction between Q and non Q wave infarction need not influence management decisions in patients after myocardial infarction.
对非Q波心肌梗死出院患者与发生Q波梗死患者的运动试验特征、冠状动脉解剖结构及预后进行了比较。在研究的339例患者中,年龄均小于或等于70岁,其中87例(26%)发生非Q波梗死。两组运动试验特征无显著差异,在接受血管造影的149例患者中,Q波组114例中有36例(32%)存在三支血管病变,非Q波组35例中有9例(26%)存在三支血管病变。非Q波组梗死相关动脉通畅率更高(27/35,77%),高于Q波组(53/114,46%)。两组的一年死亡率、再梗死率和心绞痛发生率相似,运动试验仍是预测两组未来心脏事件风险患者的良好鉴别方法。鉴于年龄小于或等于70岁的非Q波梗死患者的结局和冠心病严重程度相似,Q波梗死与非Q波梗死的区分无需影响心肌梗死后患者的管理决策。