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Exner, Derek V., MD, MPH; Kavanagh, Katherine M., MD; Slawnych, Michael P., MD, PhD; Mitchell, L. Brent, MD; Ramadan, Darlene, BSN; Aggarwal, Sandeep G., MD; Noullett, Catherine, RN; Van Schaik, Allie, RN; Mitchell, Ryan T., BSc; Shibata, Mariko A., BSc; Gulamhussein, Sajad, MD; McMeekin, James, MD; Tymchak, Wayne, MD; Schnell, Gregory, MD; Gillis, Anne M., MD; Sheldon, Robert S., MD, PhD; Fick, Gordon H., PhD; Duff, Henry J., MD
Journal of the American College of Cardiology, 12/2007, Letnik: 50, Številka: 24Journal Article
Noninvasive Risk Assessment Early After a Myocardial Infarction: The REFINE Study Derek V. Exner, Katherine M. Kavanagh, Michael P. Slawnych, L. Brent Mitchell, Darlene Ramadan, Sandeep G. Aggarwal, Catherine Noullett, Allie Van Schaik, Ryan T. Mitchell, Mariko A. Shibata, Sajad Gulamhussein, James McMeekin, Wayne Tymchak, Gregory Schnell, Anne M. Gillis, Robert S. Sheldon, Gordon H. Fick, Henry J. Duff, for the REFINE Investigators A group of 322 patients underwent testing at 2 to 4 weeks and 10 to 14 weeks after myocardial infarction (MI). Only the assessment at 10 to 14 weeks after MI reliably identified patients at risk of the primary outcome (cardiac death or cardiac arrest). The combination of impaired heart rate turbulence, abnormal exercise repolarization alternans, and an ejection fraction < 0.50 beyond 8 weeks after MI identified patients with over a 5-fold higher risk. Most patients at risk were identified, with good positive (23%) and negative (95%) predictive accuracy. This approach reliably identifies patients at risk of serious events when measured early after MI.
