Q wave and Non-Q wave XXXX after thrombolysis.

@entity1 @entity712 @entity908 @entity1188 @entity583
OBJECTIVES: We studied the clinical outcome of Q wave and non-Q wave @entity1188 after thrombolytic therapy. BACKGROUND: Controversy exists over the clinical significance of Q waves after thrombolysis. METHODS: We studied postthrombolytic angiographic results and short- and long-term clinical outcome in 150 @entity1 with acute @entity583 classified as Q wave and non-Q wave on the 24-h and discharge electrocardiograms (ECGs). The results from the two groups were then compared. RESULTS: Eighty percent of @entity1 had a Q wave and 20% a non-Q wave @entity1188 on the 24-h ECG. The latter @entity1 had lower peak @entity908 kinase (CK) levels (p < 0.001), but the two groups did not differ significantly otherwise. In 18 @entity1 with a Q wave @entity1188 on the 24-h ECG, pathologic Q waves disappeared. However, in seven @entity1 with a non-Q wave @entity1188 on the 24-h ECG, pathologic Q waves appeared throughout the hospital period. Q wave regression was associated with lower peak CK levels (p < 0.001) and an improvement in left ventricular ejection fraction (p < 0.01). Thus, only 72% of @entity1 had a Q wave and 28% a non-Q wave @entity1188 on the discharge ECG. @entity1 with a non-Q wave @entity1188 on the discharge ECG had higher patency of the @entity1188 (p < 0.04), lower mean peak CK levels (p < 0.0001), a higher ejection fraction (p = 0.001) and a lower incidence of @entity712 (p = 0.06) than @entity1 with a Q wave @entity1188 on the discharge ECG. Although the 2-year incidence of reinfarction and revascularization was higher in @entity1 with a non-Q wave @entity1188 on the discharge ECG (p < 0.05), 2-year mortality was lower (p = 0.08). CONCLUSIONS: Although the early postthrombolytic distinction between Q wave and non-Q wave @entity1188 conveys no significant information, during the hospital period, non-Q wave @entity1188 is associated with a smaller @entity1188 area, improved left ventricular function and lower mortality.
