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  • Title: Bedside risk stratification after acute myocardial infarction: prospective evaluation of the use of heart rate and left ventricular function.
    Author: Mauss O, Klingenheben T, Ptaszynski P, Hohnloser SH.
    Journal: J Electrocardiol; 2005 Apr; 38(2):106-12. PubMed ID: 15892019.
    Abstract:
    OBJECTIVE: This study evaluated the predictive power of heart rate (HR) assessed from the standard 12-lead electrocardiogram (ECG) or from Holter recordings for future mortality and arrhythmic events in survivors of acute myocardial infarction (AMI). METHODS: Data from 432 consecutive survivors of AMI (343 men, 89 women; mean [SD] age, 58 [11] years) were analyzed. Heart rate was assessed from a standard 12-lead ECG and from 24-hour Holter recordings obtained at hospital discharge. In addition, left ventricular ejection fraction (LVEF) was noninvasively determined. The study end point was prospectively defined as a composite end point comprising mortality and arrhythmic events (ie, sudden death, resuscitated ventricular fibrillation, sustained ventricular tachycardia). Patients were followed for an average (SD) of 41 (25) months. RESULTS: Patient age, LVEF, and HR were univariate risk predictors of event-free survival. Multivariate analysis by means of a stepwise regression analysis revealed LVEF ( chi2 11.4, P = .0007), age ( chi 2 9.2, P = .02), and HR assessed from the standard 12-lead ECG ( chi2 7.1, P = .008) as independent risk parameters. CONCLUSIONS: Bedside risk stratification of survivors of AMI is feasible using simple parameters such as age, LVEF, and HR.
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