Silent Ischemia on Holter Monitoring Predicts Mortality in High-Risk Postinfarction Patients

Sidney Gottlieb, Sheldon Gottlieb, Stephen C Achuff, Rosemary Baumgardner, E. David Mellits, Myron Weisfeldt, Gary Gerstenblith

Research output: Contribution to journalArticle

Abstract

The relative prognostic significance of ischemic ST changes on two-lead continuous electrocardiographic (Holter) monitoring in 103 high-risk postinfarction patients was examined. Ischemic ST changes were detected in 30 patients, with a median number of five episodes per day and median total daily duration of 157 minutes. Only one third of these patients reported any angina in the hospital, and 28 of the 30 patients had silent ST changes on Holter monitoring. The remaining 73 patients had no ischemic ST changes on Holter monitoring. At one year, nine (30%) of 30 patients with ischemic ST changes were dead vs only eight (11%) of 73 patients without such changes. Multivariate Cox’s hazard function analysis on 18 variables, including age, type of infarction, Lown and Killip class, ejection fraction, and medications, showed that the presence of ST changes on Holter monitoring was a significant predictive variable for one-year mortality in the overall study population and particularly in the subgroup of 59 patients who could not undergo early exercise treadmill testing. Thus, ischemic ST changes on Holter monitoring, the majority of which are silent, occur in nearly one third of high-risk postinfarction patients and are significantly associated with one-year mortality.

Original languageEnglish (US)
Pages (from-to)1030-1035
Number of pages6
JournalJournal of the American Medical Association
Volume259
Issue number7
DOIs
StatePublished - Feb 19 1988

Fingerprint

Ambulatory Electrocardiography
Ischemia
Mortality
Infarction
Exercise

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Silent Ischemia on Holter Monitoring Predicts Mortality in High-Risk Postinfarction Patients. / Gottlieb, Sidney; Gottlieb, Sheldon; Achuff, Stephen C; Baumgardner, Rosemary; Mellits, E. David; Weisfeldt, Myron; Gerstenblith, Gary.

In: Journal of the American Medical Association, Vol. 259, No. 7, 19.02.1988, p. 1030-1035.

Research output: Contribution to journalArticle

@article{351ddb3cf4c045e0b16e8e33df9582f2,
title = "Silent Ischemia on Holter Monitoring Predicts Mortality in High-Risk Postinfarction Patients",
abstract = "The relative prognostic significance of ischemic ST changes on two-lead continuous electrocardiographic (Holter) monitoring in 103 high-risk postinfarction patients was examined. Ischemic ST changes were detected in 30 patients, with a median number of five episodes per day and median total daily duration of 157 minutes. Only one third of these patients reported any angina in the hospital, and 28 of the 30 patients had silent ST changes on Holter monitoring. The remaining 73 patients had no ischemic ST changes on Holter monitoring. At one year, nine (30{\%}) of 30 patients with ischemic ST changes were dead vs only eight (11{\%}) of 73 patients without such changes. Multivariate Cox’s hazard function analysis on 18 variables, including age, type of infarction, Lown and Killip class, ejection fraction, and medications, showed that the presence of ST changes on Holter monitoring was a significant predictive variable for one-year mortality in the overall study population and particularly in the subgroup of 59 patients who could not undergo early exercise treadmill testing. Thus, ischemic ST changes on Holter monitoring, the majority of which are silent, occur in nearly one third of high-risk postinfarction patients and are significantly associated with one-year mortality.",
author = "Sidney Gottlieb and Sheldon Gottlieb and Achuff, {Stephen C} and Rosemary Baumgardner and Mellits, {E. David} and Myron Weisfeldt and Gary Gerstenblith",
year = "1988",
month = "2",
day = "19",
doi = "10.1001/jama.1988.03720070030029",
language = "English (US)",
volume = "259",
pages = "1030--1035",
journal = "JAMA - Journal of the American Medical Association",
issn = "0098-7484",
publisher = "American Medical Association",
number = "7",

}

TY - JOUR

T1 - Silent Ischemia on Holter Monitoring Predicts Mortality in High-Risk Postinfarction Patients

AU - Gottlieb, Sidney

AU - Gottlieb, Sheldon

AU - Achuff, Stephen C

AU - Baumgardner, Rosemary

AU - Mellits, E. David

AU - Weisfeldt, Myron

AU - Gerstenblith, Gary

PY - 1988/2/19

Y1 - 1988/2/19

N2 - The relative prognostic significance of ischemic ST changes on two-lead continuous electrocardiographic (Holter) monitoring in 103 high-risk postinfarction patients was examined. Ischemic ST changes were detected in 30 patients, with a median number of five episodes per day and median total daily duration of 157 minutes. Only one third of these patients reported any angina in the hospital, and 28 of the 30 patients had silent ST changes on Holter monitoring. The remaining 73 patients had no ischemic ST changes on Holter monitoring. At one year, nine (30%) of 30 patients with ischemic ST changes were dead vs only eight (11%) of 73 patients without such changes. Multivariate Cox’s hazard function analysis on 18 variables, including age, type of infarction, Lown and Killip class, ejection fraction, and medications, showed that the presence of ST changes on Holter monitoring was a significant predictive variable for one-year mortality in the overall study population and particularly in the subgroup of 59 patients who could not undergo early exercise treadmill testing. Thus, ischemic ST changes on Holter monitoring, the majority of which are silent, occur in nearly one third of high-risk postinfarction patients and are significantly associated with one-year mortality.

AB - The relative prognostic significance of ischemic ST changes on two-lead continuous electrocardiographic (Holter) monitoring in 103 high-risk postinfarction patients was examined. Ischemic ST changes were detected in 30 patients, with a median number of five episodes per day and median total daily duration of 157 minutes. Only one third of these patients reported any angina in the hospital, and 28 of the 30 patients had silent ST changes on Holter monitoring. The remaining 73 patients had no ischemic ST changes on Holter monitoring. At one year, nine (30%) of 30 patients with ischemic ST changes were dead vs only eight (11%) of 73 patients without such changes. Multivariate Cox’s hazard function analysis on 18 variables, including age, type of infarction, Lown and Killip class, ejection fraction, and medications, showed that the presence of ST changes on Holter monitoring was a significant predictive variable for one-year mortality in the overall study population and particularly in the subgroup of 59 patients who could not undergo early exercise treadmill testing. Thus, ischemic ST changes on Holter monitoring, the majority of which are silent, occur in nearly one third of high-risk postinfarction patients and are significantly associated with one-year mortality.

UR - http://www.scopus.com/inward/record.url?scp=0023872979&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023872979&partnerID=8YFLogxK

U2 - 10.1001/jama.1988.03720070030029

DO - 10.1001/jama.1988.03720070030029

M3 - Article

C2 - 3339800

AN - SCOPUS:0023872979

VL - 259

SP - 1030

EP - 1035

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0098-7484

IS - 7

ER -