Title
Differences between local hospital and core laboratory interpretation of the admission electrocardiogram in patients with acute coronary syndromes and their relation to outcome
UMMS Affiliation
Center for Outcomes Research; Department of Medicine, Division of Cardiovascular Medicine
Publication Date
2007-07-17
Document Type
Article
Subjects
Aged; Coronary Disease; Diagnostic Tests, Routine; Electrocardiography; Female; Humans; Laboratories; Male; Myocardial Infarction; Prospective Studies
Disciplines
Health Services Research
Abstract
In the prospective, multinational Global Registry of Acute Coronary Events (GRACE), patients diagnosed with non-ST-elevation acute coronary syndromes had their admission electrocardiogram independently evaluated by a central core laboratory, and its interpretation by the core laboratory and enrolling site were compared. One in 6 of these patients had clinically important features of left-bundle branch block or ST-segment deviation diagnosed by the core laboratory that were apparently not recognized at the local sites; this subgroup of patients was less likely to undergo risk stratification and revascularization. Importantly, failure to recognize these features as confirmed by the core laboratory in routine clinical practice was independently associated with higher mortality and recurrent myocardial infarction at 6 months (adjusted odds ratio 1.41, 95% confidence interval 1.01 to 1.96, p = 0.043). In conclusion, these findings underscore an urgent need to promote more accurate interpretation of electrocardiograms in contemporary clinical practice to bridge treatment gaps and improve patient outcome.
DOI of Published Version
10.1016/j.amjcard.2007.02.074
Source
Am J Cardiol. 2007 Jul 15;100(2):169-74. Epub 2007 Jun 4. Link to article on publisher's site
Journal/Book/Conference Title
The American journal of cardiology
Related Resources
PubMed ID
17631063
Repository Citation
Yan RT, Yan AT, Allegrone J, Lopez-Sendon J, Granger CB, Gore JM, Budaj A, Georgescue AA, Hassan Q, Luchansky J, Van de Werf F, Goodman SG. (2007). Differences between local hospital and core laboratory interpretation of the admission electrocardiogram in patients with acute coronary syndromes and their relation to outcome. GRACE Publications. https://doi.org/10.1016/j.amjcard.2007.02.074. Retrieved from https://escholarship.umassmed.edu/cor_grace/54