Hlatky M A, Califf R M, Lee K L, Pryor D B, Wagner G S, Rosati R A
Am J Cardiol. 1985 Feb 1;55(4):325-9. doi: 10.1016/0002-9149(85)90369-8.
To study the mechanism and prognostic importance of precordial ST-segment depression during inferior acute myocardial infarction, 162 patients admitted during 1969 through 1982 were identified. Patients with ST depression in leads V1, V2 and V3 had significantly larger infarctions as assessed by a QRS scoring system. Hospital mortality was 4% (3 of 75) among patients without ST depression, and 13% (11 of 87) in patients with ST depression. The relation between the amount of ST depression and hospital mortality was significant (p less than 0.001 by logistic regression), and remained significant (p less than 0.003) after adjusting for other potentially prognostic factors. Among patients discharged from the hospital, the 5-year survival was 92% in those without precordial ST depression and 80% in those with precordial ST depression (p = 0.058 by the Cox model). Precordial ST-segment depression on the admission electrocardiogram during an inferior acute myocardial infarction indicates a larger infarction, predicts a higher hospital mortality and suggests a worse long-term prognosis after discharge.
为研究下壁急性心肌梗死时胸前导联ST段压低的机制及预后意义，我们确定了1969年至1982年间收治的162例患者。根据QRS评分系统评估，V1、V2和V3导联出现ST段压低的患者梗死面积显著更大。无ST段压低的患者医院死亡率为4%（75例中有3例），有ST段压低的患者为13%（87例中有11例）。ST段压低程度与医院死亡率之间的关系具有显著性（逻辑回归分析p<0.001），在对其他潜在预后因素进行校正后仍具有显著性（p<0.003）。出院患者中，无胸前导联ST段压低者5年生存率为92%，有胸前导联ST段压低者为80%（Cox模型分析p = 0.058）。下壁急性心肌梗死入院心电图出现胸前导联ST段压低提示梗死面积更大，预测医院死亡率更高，且提示出院后长期预后更差。
