Herlitz J, Karlson B W, Bång A, Sjölin M
Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden.
Cardiology. 1998;89(1):33-9. doi: 10.1159/000006741.
We related observations in the electrocardiogram (ECG) on admission to hospital among consecutive patients hospitalized in one single hospital with acute myocardial infarction (AMI) and related the prognosis during the following 5 years to these observations.
Of 863 patients, 63% had ECG signs of myocardial ischemia, but only 41% had ST elevation on ED admission. Patients with ST elevation had a 5-year mortality of 44% as compared with 58% in patients without ST elevation (p < 0.001). Patients with the highest mortality were those with a pathologic ECG including signs of previous AMI, bundle branch block and pacemaker ECG, but with no ECG sign of acute ischemia. Patients with the lowest mortality were those with a nonpathologic ECG on admission.
Among consecutive patients hospitalized with AMI, less than half had ST elevation on admission to hospital. These patients had a lower mortality during 5 years of follow-up than patients without ST elevation.
我们将一家医院连续收治的急性心肌梗死（AMI）患者入院时的心电图（ECG）表现进行关联，并将接下来5年的预后情况与这些表现相关联。
在863例患者中，63%有心肌缺血的心电图表现，但急诊入院时仅有41%有ST段抬高。ST段抬高患者的5年死亡率为44%，而无ST段抬高患者为58%（p<0.001）。死亡率最高的患者是那些有病理心电图表现的患者，包括既往AMI迹象、束支传导阻滞和起搏器心电图，但无急性缺血的心电图表现。死亡率最低的患者是入院时心电图无病理表现的患者。
在连续收治的AMI患者中，入院时不到一半的患者有ST段抬高。在5年随访期间，这些患者的死亡率低于无ST段抬高的患者。
