rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2010-6-6-812-817rpcardio-924Research ArticleORIGINAL STUDIESОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯPROGNOSTIC VALUE OF PATHOLOGIC Q-WAVE AND TIME OF ITS APPEARANCE IN PATIENTS WITH MYOCARDIAL INFARCTION: COMPARISON STUDYСРАВНИТЕЛЬНАЯ ОЦЕНКА БЛИЖАЙШЕГО И ОТДАЛЕННОГО ПРОГНОЗА БОЛЬНЫХ ИНФАРКТОМ МИОКАРДА В ЗАВИСИМОСТИ ОТ НАЛИЧИЯ И ВРЕМЕНИ ВОЗНИКНОВЕНИЯ ПАТОЛОГИЧЕСКОГО ЗУБЦА QШульманВ. А.ShulmanV. A.

д.м.н., профессор, зав. кафедрой внутренних болезней № 1 

660022, Красноярск, ул. Партизана Железняка, 1 

Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022

ГоловенкинС. Е.GolovenkinS. E.

к.м.н., доцент кафедры внутренних болезней № 1 

660022, Красноярск, ул. Партизана Железняка, 1 

Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022

gse2008@mail.ruСимулинВ. Н.SimulinV. N.

к.м.н., врач отделения реанимации и интенсивной терапии 

660014, Красноярск, ул. Инструментальная, 12

Instrumentalnaya ul 12, Krasnoyarsk, 660014

РадионовВ. В.RadionovV. V.

к.м.н., заведующий отделением реанимации и интенсивной терапии 

660014, Красноярск, ул. Инструментальная, 12

Instrumentalnaya ul 12, Krasnoyarsk, 660014

МатюшинГ. В.MatyushinG. V.

д.м.н., профессор, заведующий кафедрой кардиологии и функциональной диагностики

660022, Красноярск, ул. Партизана Железняка, 1 

Partizana Zheleznyaka ul. 1, Krasnoyarsk, 660022

Красноярский государственный медицинский университет им. проф. В.Ф. Войно-ЯсенецкогоРоссияKrasnoyarsk State Medical University named after professor V.F. Voyno-YasenetskyRussian FederationГородская клиническая больница № 20 им. И.С. БерзонаРоссияCity Clinical Hospital №20 named after I.S. BerzonRussian Federation20102001201666812817Copyright © Shulman V.A., Golovenkin S.E., Simulin V.N., Radionov V.V., Matyushin G.V., 20162016Шульман В.А., Головенкин С.Е., Симулин В.Н., Радионов В.В., Матюшин Г.В.Shulman V.A., Golovenkin S.E., Simulin V.N., Radionov V.V., Matyushin G.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/924Aim

Aim. To evaluate short- and long-term prognosis of myocardial infarction (MI) depending on occurrence of pathologic Q-wave on ECG and time of its appearance.

Material and methods

Material and methods. 616 patients with initial ST-elevated MI were included into the study — 254 women and 362 men, aged 62.1±11.2. All patients were split up three groups depending on occurrence of pathologic Q-wave on ECG and time of its appearance. First group consisted of 311 patients with early Q-wave (during first 6 hours from onset of MI symptoms). Second group consisted of 120 patients with late Q-wave (from 6 to 24 hours from onset of MI symptoms). Third group consisted of 185 patients with non-Q-wave MI.

Results

Results. The hospital lethality in the patients with early Q-wave was significantly higher than this in patients of the second and the third groups. However, we didn’t reveal significant differences between patients with late Q-wave and patients without Q-wave on ECG. The incidences of cardiac death (sudden death and fatal MI), non-fatal MI and hospitalization because of unstable angina was assessed during next two years. During the follow-up period patients of three groups had similar incidences of the non-fatal MI and hospitalization because of unstable angina. However, incidence of cardiac death was significantly higher in early Q-wave group in comparison with non-Q-wave group.

Цель

Цель. Оценить ближайший и отдаленный прогноз инфаркта миокарда (ИМ) в зависимости от наличия или отсутствия патологического зубца Q на ЭКГ, а также от времени возникновения этого зубца.

Материал и методы

Материал и методы. В исследование включены 616 больных первичным ИМ с подъемом сегмента ST. Женщин было 254, мужчин — 362. Возраст больных составлял 62,1±11,9 лет. Больные были распределены на 3 группы. В 1-ю группу вошли 311 больных с ранним (до 6 ч) возникновением патологического зубца Q (ранний Q-ИМ). 2-я группа состояла из 120 больных ИМ с поздним (6-24 ч) возникновением зубца Q (поздний Q-ИМ), 3-ю группу составили 185 больных ИМ без зубца Q (не Q-ИМ).

Результаты

Результаты. Госпитальная летальность больных с ранним Q-ИМ достоверно превосходила летальность не только больных с не Q-ИМ, но и пациентов с поздним Q-ИМ. В то же время, летальность больных с поздним Q-ИМ достоверно не отличалась от летальности больных с не Q-ИМ. За два года наблюдения не было достоверных различий в частоте случаев госпитализации по поводу нестабильной стенокардии и повторных нефатальных ИМ в рассматриваемых группах больных. Однако частота случаев коронарной смерти (сумма случаев внезапной смерти и фатального ИМ) в группе больных с ранним Q-ИМ оказалась достоверно большей по сравнению с группой не Q-ИМ.

Заключение

Заключение. При оценке ближайшего и отдаленного прогноза больных ИМ необходимо учитывать не только наличие (или отсутствие) на ЭКГ патологического зубца Q, но также и время возникновения этого зубца.

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The authors declare that there are no conflicts of interest present.