PROGNOSIS FOLLOWING ACUTE MYOCARDIAL-INFARCTION IN PATIENTS WITH ECG EVIDENCE OF LEFT-VENTRICULAR HYPERTROPHY PRIOR TO INFARCTION

This study was designed to determine the relationship between prognosi s after myocardial infarction (MI) and left ventricular hypertrophy (L VH). Left ventricular hypertrophy diagnosed by electrocardiography acc ording to the criteria of Sokolow and Lyon was noted in 57 of 223 pati ents (25.6%) on the pre-MI electrocardiogram (ECG), in 11.2% on an ear ly post MI EGG, and in 11.3% on the discharge EGG. In-hospital and 1-y ear postdischarge mortalities were significantly greater in patients w ith LVH noted on pre-MI ECG than in patients without prior LVH. There was no relationship bt tween the presence of LVH on early post-MI ECGs and in-hospital or postdischarge 1-year mortality. Multivariate analy sis revealed that evidence of LVH on a pre-MI ECG and acute congestive heart failure were independent predictors of cardiac death within 1 y ear of MI in patients over 70 years old. It is concluded that in patie nts over 70 years of age, the presence of LVH on a pre-MI ECG is a rel iable predictor of post-MI prognosis.