{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T23:53:38Z","timestamp":1760745218302,"version":"build-2065373602"},"reference-count":24,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2003,1]]},"abstract":"<jats:p>\n                  <jats:bold>Objectives:<\/jats:bold> To determine the incremental value of clinical data, troponin T, ST segment monitoring, and heart rate variability for predicting outcome in patients with non-ST elevation acute coronary syndromes.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Methods:<\/jats:bold> Prospective cohort study of 304 consecutive patients. Baseline clinical and electrocardiographic data were recorded, serial blood samples were obtained for troponin T assay, and 48 hour Holter monitoring was performed for ST segment and heart rate variability analysis. End points were cardiac death and non-fatal myocardial infarction during 12 months\u2019 follow up.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Results:<\/jats:bold> After 12 months, 7 patients had died and 21 had had non-fatal myocardial infarction. The risk of an event was increased by troponin T &gt; 0.1 \u03bcg\/l, T wave inversion on the presenting ECG, Holter ST shift, and a decrease in the standard deviation of 5 minute mean RR intervals. Positive predictive values of individual multivariate risk were low; however, analysis of all multivariate risk markers permitted calculation of a cumulative risk score, which increased the positive predictive value to 46.9% while retaining a negative predictive value of 96.9%.<\/jats:p>\n               <jats:p>\n                  <jats:bold>Conclusion:<\/jats:bold> A cumulative approach to risk stratification in non-ST elevation coronary syndromes successfully identifies a group in whom the risk of cardiac death or non-fatal myocardial infarction approaches 50%.<\/jats:p>","DOI":"10.1136\/heart.89.1.36","type":"journal-article","created":{"date-parts":[[2002,12,13]],"date-time":"2002-12-13T17:04:29Z","timestamp":1039799069000},"page":"36-41","source":"Crossref","is-referenced-by-count":9,"title":["Cumulative risk assessment in unstable angina: clinical, electrocardiographic, autonomic, and biochemical 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