Improvement of risk-stratification by use of a new combination of Holter variables in survivors of XXXX .

@entity1 @entity583 @entity204 @entity1165
OBJECTIVE: Holter monitoring is one option in risk-stratification after acute @entity583 ( @entity583 ). Measurements of heart rate variability (HRV), @entity1165 ( @entity1165 ) and ST-segment elevation (ST upward arrow ) have been useful in predicting clinical outcome. We investigated if a combination of different Holter variables could optimize risk-stratification. DESIGN: One hundred and twenty-one @entity1 < 70 years old with a first @entity583 were studied. Holter monitoring for 24 h was started 11 +/- 5 days after @entity583 and analysed for HRV, @entity1165 and ST. Follow-up was 10-12 years with @entity204 as endpoint. RESULTS: Thirty-six @entity1 were positive for > or = 1 Holter variable (HRV in 15, @entity1165 in 16, ST in 10). At follow-up 22 @entity204 had occurred. The prognostic sensitivity of individual Holter variables ranged from 23 to 36%, but increased to 64% if combined. The @entity204 rate in Holter positive @entity1 (39%) was significantly higher than in Holter negative @entity1 (9%) (p < 0.0001). CONCLUSION: By combining measurements of HRV, @entity1165 and ST the prognostic importance of Holter monitoring can be significantly improved. The @entity1 can be stratified in a low-risk group with an annual mortality < 1% vs a high-risk group with a @entity204 rate around 40% over the following decade.
