PROGNOSTIC INFORMATION FROM ONLINE VECTORCARDIOGRAPHY IN UNSTABLE ANGINA-PECTORIS

The prognostic information from 24-hour monitoring with on-line vector cardiography (VCG) was assessed in 100 patients with a clinical diagno sis of unstable angina pectoris. ST change vector magnitude, ST vector magnitude and QRS vector difference were monitored. During a follow-u p period of 343 +/- 77 days, 7 patients died from cardiac causes and 8 patients had a nonfatal myocardial infarction (MI). Thirty patients w ere readmitted for unstable angina pectoris and 36 were revascularized because of medical refractory angina. Univariate predictors of cardia c death or nonfatal MI included greater age, rest pain during hospital ization, previous MI, diabetes mellitus and high incidence of supposed ly ischemic transient ST and QRS vector changes. In multivariate analy sis, a high incidence of transient ST (p < 0.01) and QRS (p < 0.01) ve ctor changes provided additional prognostic information beyond that of clinical and exercise test data. In conclusion, VCG monitoring during the first 24 h of hospitalization for unstable angina pectoris identi fies patients with increased risk of adverse cardiac events.