{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T18:26:46Z","timestamp":1760898406331},"reference-count":20,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T00:00:00Z","timestamp":1499731200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST\u2010segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and\/or rapidity of revascularization based on the guideline\u2010based metric of door\u2010to\u2010balloon time remains unknown.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS\u2010AMI) trial enrolled 3602 patients with STEMI undergoing primary percutaneous coronary intervention. We stratified patients without prior history of myocardial infarction or coronary revascularization according to presence or absence of pathological Q waves on their presenting ECG. Associations between Q waves, death, and cardiovascular outcomes within 3 years were assessed using Cox proportional hazards regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 2723 patients with evaluable ECGs, 1084 (39.8%) had Q waves on their presenting ECG. Male sex and time from symptom onset to balloon inflation were independent predictors of presence of Q waves. Patients with Q waves had higher adjusted risks of all\u2010cause death (adjusted hazard ratio: 1.45, 95% confidence interval: 1.02\u20102.05, <jats:italic>P<\/jats:italic> = 0.04) and cardiac death (adjusted hazard ratio: 1.72, 95% confidence interval: 1.08\u20102.72, <jats:italic>P<\/jats:italic> = 0.02). The association between Q waves and cardiac death was consistent regardless of sex, diabetes status, target vessel, or door\u2010to\u2010balloon time (<jats:italic>P<\/jats:italic><jats:sub>interaction<\/jats:sub> &gt; 0.4 for all).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Presence of Q waves on the presenting ECG in patients undergoing primary percutaneous coronary intervention due to STEMI is an independent predictor of mortality and adds prognostic value, regardless of sex or rapidity of revascularization.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22751","type":"journal-article","created":{"date-parts":[[2017,7,11]],"date-time":"2017-07-11T13:12:44Z","timestamp":1499778764000},"page":"982-987","source":"Crossref","is-referenced-by-count":11,"title":["Prognostic implications of Q waves at presentation in patients with ST\u2010segment elevation myocardial infarction undergoing primary percutaneous coronary intervention: An analysis of the HORIZONS\u2010AMI study"],"prefix":"10.1002","volume":"40","author":[{"given":"Ioanna","family":"Kosmidou","sequence":"first","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"},{"name":"Center for Interventional Vascular Therapy, Division of Cardiology New York\u2010Presbyterian Hospital\/Columbia University Medical Center  New York City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f6rn","family":"Redfors","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaron","family":"Crowley","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernard","family":"Gersh","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Mayo Clinic College of Medicine and Science  Rochester Minnesota"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shmuel","family":"Chen","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jos\u00e9 M.","family":"Dizon","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"},{"name":"Center for Interventional Vascular Therapy, Division of Cardiology New York\u2010Presbyterian Hospital\/Columbia University Medical Center  New York City"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Monica","family":"Embacher","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Mehran","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"},{"name":"The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ori","family":"Ben\u2010Yehuda","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gary S.","family":"Mintz","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregg W.","family":"Stone","sequence":"additional","affiliation":[{"name":"Clinical Trials Center, Cardiovascular Research Foundation  New York City New York"},{"name":"Center for Interventional Vascular Therapy, Division of Cardiology New York\u2010Presbyterian Hospital\/Columbia University Medical Center  New York City"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,7,11]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.111683"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2009.01.046"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68929-0"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2009.11.013"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61484-7"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708191"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(82)90235-1"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.65.2.342"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)60107-0"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.12.057"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.110.959544"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.01.069"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehx159"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.11.019"},{"key":"e_1_2_6_16_1","first-page":"774","article-title":"The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: a continual challenge","volume":"38","author":"Heusch G","year":"2017","journal-title":"Eur Heart J."},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/1479164111427752"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000396"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2005.07.022"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.55.2.279"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2015.03.005"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fclc.22751","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.22751","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T19:22:52Z","timestamp":1695496972000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.22751"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,7,11]]},"references-count":20,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1002\/clc.22751"],"URL":"https:\/\/doi.org\/10.1002\/clc.22751","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,7,11]]}}}