American Journal of Cardiology
Volume 82, Issue 1 , Pages 54-60 , 1 July 1998

Differences between local investigator and core laboratory interpretation of the admission electrocardiogram in patients with unstable angina pectoris or non–q-wave myocardial infarction (a thrombin inhibition in myocardial ischemia [trim] substudy)

  • Lene Holmvang, MD

      Affiliations

    • Heart Center, Rigshospitalet, Copenhagen, Denmark
    • Corresponding Author InformationAddress for reprints: Lene Holmvang, MD, The Heart Center, 2142, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark
    • ,
  • Philip Hasbak, MD

      Affiliations

    • Heart Center, Rigshospitalet, Copenhagen, Denmark
    • ,
  • Peter Clemmensen, MD, PhD

      Affiliations

    • Heart Center, Rigshospitalet, Copenhagen, Denmark
    • ,
  • Galen Wagner, MD

      Affiliations

    • Duke University Medical Center, Durham, North Carolina, USA
    • ,
  • Peer Grande, MD, PhD

      Affiliations

    • Heart Center, Rigshospitalet, Copenhagen, Denmark

Received 29 December 1997 ,Revised 20 February 1998 ,Accepted 20 February 1998.

References 

  1. Fibrinolytic Therapy Trialists’ (FTT) Collaborative Group . Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomised trials of more than 1000 patients. Lancet. 1994;343:311–322
  2. The Global Use of Strategies to Open Occluded Coronary Arteries (GUSTO) IIb Investigators . A comparison of recombinant hirudin with heparin for the treatment of acute coronary syndromes. N Engl J Med. 1996;335:775–782
  3. Theroux P, Ouimet H, McCans J, Latour JG, Joly P, Levy G, et al. Aspirin, heparin, or both to treat acute unstable angina. N Engl J Med. 1988;319:1105–1111
  4. Fragmin during Instability in Coronary Artery Disease (FRISC) Study Group . Low-molecular-weight heparin during instability in coronary artery disease. Lancet. 1996;347:561–568
  5. The TIMI IIB Study Group . Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI IIIB Trial. Thrombolysis in Myocardial Ischemia. Circulation. 1994;89:1545–1556
  6. Peterson ED, Hathaway WR, Zabel KM, Pieper KS, Granger CB, Wagner GS, et al. Prognostic significance of precordial ST segment depression during inferior myocardial infarction in the thrombolytic era (results in 16,521 patients). J Am Coll Cardiol. 1996;28:305–312
  7. Sgarbossa EB, Pinski SL, Barbagelata A, Underwood DA, Gates KB, Topol EJ, et al. Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) Investigators. N Engl J Med. 1996;334:481–487
  8. Klootwijk P, Langer A, Meij S, Green C, Veldkamp RF, Ross AM, et al. Non-invasive prediction of reperfusion and coronary artery patency by continuous ST segment monitoring in the GUSTO-I trial. Eur Heart J. 1996;17:689–698
  9. Chaitman BR, Rosen AD, Williams DO, Bourassa MG, Aguirre FV, Pitt B, et al. Myocardial infarction and cardiac mortality in the Bypass Angioplasty Revascularization Investigation (BARI) randomized trial. Circulation. 1997;96:2162–2170
  10. The TRIM Study Group . A low molecular weight, specific thrombin inhibitor, Inogatran, versus heparin, in unstable coronary artery disease in 1209 patients (a double blind, randomized dose finding study). Eur Heart J. 1997;18:1416–1425
  11. Nyman I, Areskog M, Areskog NH, Swahn E, Wallentin L. Very early risk stratification by electrocardiogram at rest in men with suspected unstable coronary heart disease. The RISC Study Group. J Intern Med. 1993;234:293–301
  12. Cannon CP, McCabe CH, Stone PH, Rogers WJ, Schactman M, Thompson BW, et al. The electrocardiogram predicts one-year outcome of patients with unstable angina and non-Q wave myocardial infarction: results of the TIMI III Registry ECG Ancillary Study. Thrombolysis in Myocardial Ischemia. J Am Coll Cardiol. 1997;30:133–140
  13. Altman DG. In: Practical Statistics for Medical Research. London: Chapman and Hall; 1991;p. 403–407
  14. Okin PM, Bergman G, Kligfield P. Effect of ST segment measurement point on performance of standard and heart rate-adjusted ST segment criteria for the identification of coronary artery disease. Circulation. 1991;84:57–66
  15. Sirnes PA, Myreng Y, Molstad P, Golf S. Reproducibility of quantitative coronary analysis, assessment of variability due to frame selection, different observers, and different cinefilmless laboratories. Int J Card Imaging. 1996;12:197–203
  16. Kronik G, Stollberger C, Schuh M, Abzieher F, Slany J, Schneider B. Interobserver variability in the detection of spontaneous echo contrast, left atrial thrombi, and left atrial appendage thrombi by transoesophageal echocardiography. Br Heart J. 1995;74:80–83
  17. Herbert ME, Votey SR, Morgan MT, Cameron P, Dziukas L. Failure to agree on the electrocardiographic diagnosis of ventricular tachycardia. Ann Emerg Med. 1996;27:35–38
  18. Gjorup T, Kelbaek H, Nielsen D, Kreiner S, Godtfredsen J. Interpretation of the electrocardiogram in suspected myocardial infarction (a randomized controlled study of the effect of a training programme to reduce interobserver variation). J Intern Med. 1992;231:407–412
  19. The Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy Investigators . A clinical trial comparing primary coronary angioplasty with tissue plasminogen activator for acute myocardial infarction. N Engl J Med. 1997;336:1621–1628
  20. Gjorup T, Kelbaek H, Stenbygard L, Sorensen F, Godtfredsen J, Jensen AM. Effect of knowledge of serum enzyme concentrations on doctors’ interpretation of electrocardiographic manifestations in suspected myocardial infarction. Br Med J (Clin Res Ed). 1986;292:27

☆ This study was supported by grants from The Beckett Foundation, “Asta Floridan Boldings Mindelegat,” and “Murermester Laurits Peter Christensen og hustru Kirsten Sigrid Christensens Fond,” Copenhagen, Denmark. The TRIM study was planned and funded by Astra-Hässle, Sweden.

PII: S0002-9149(98)00226-4

American Journal of Cardiology
Volume 82, Issue 1 , Pages 54-60 , 1 July 1998

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