{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T22:29:18Z","timestamp":1770071358612,"version":"3.49.0"},"reference-count":14,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2009,2]]},"abstract":"\n Objective:<\/jats:title>\n To discern if the prognostic meaning of QRS prolongation differs according to the location of ST elevation acute myocardial infarction<\/jats:p>\n <\/jats:sec>\n \n Design:<\/jats:title>\n Measuring QRS duration in patients with normal conduction or right bundle branch block<\/jats:p>\n <\/jats:sec>\n \n Setting:<\/jats:title>\n HERO-2 trial with prospective collection of electrocardiograms at randomisation and at 60 min after fibrinolytic therapy<\/jats:p>\n <\/jats:sec>\n \n Patients:<\/jats:title>\n 12\u00a0456 patients with normal conduction at both randomisation and 60-min time points and 510 with right bundle branch block (RBBB) at both time points<\/jats:p>\n <\/jats:sec>\n \n Main outcome measure:<\/jats:title>\n 30-day mortality.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n On the baseline ECG, there was a positive association between QRS duration and 30-day mortality with anterior acute myocardial infarction (AMI) (p<0.0001 for those with normal conduction and \u200a=\u200a0.007 for those with RBBB) but not with inferior AMI (p\u200a=\u200a0.29 and p\u200a=\u200a0.32, respectively). For anterior AMI, with or without RBBB, an increment of 20 ms increase in QRS duration predicted a significant 30\u201340% relative increase in 30-day mortality both before and after adjusting for clinical and ECG variables including baseline ST elevation and presence of Q waves. The association was not present for inferior AMI. Changes in QRS duration over 60 min after fibrinolytic therapy were uncommon and unrelated to mortality.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n Baseline QRS duration independently stratifies 30-day mortality in patients with anterior AMI, even when unaccompanied by RBBB, but does not stratify mortality risk in patients with inferior AMI.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/hrt.2008.146365","type":"journal-article","created":{"date-parts":[[2008,12,15]],"date-time":"2008-12-15T20:29:58Z","timestamp":1229372998000},"page":"276-282","source":"Crossref","is-referenced-by-count":36,"title":["Relationship of QRS duration at baseline and changes over 60 min after fibrinolysis to 30-day mortality with different locations of ST elevation myocardial infarction: results from the Hirulog and Early Reperfusion or Occlusion-2 trial"],"prefix":"10.1136","volume":"95","author":[{"given":"C-K","family":"Wong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"W","family":"Gao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R A H","family":"Stewart","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J K","family":"French","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P E G","family":"Aylward","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H D","family":"White","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2008,12,15]]},"reference":[{"key":"2025091923273187000_95.4.276.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(94)91344-7"},{"key":"2025091923273187000_95.4.276.2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(70)90359-5"},{"key":"2025091923273187000_95.4.276.3","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi622"},{"key":"2025091923273187000_95.4.276.4","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.639039"},{"key":"2025091923273187000_95.4.276.5","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00372-X"},{"key":"2025091923273187000_95.4.276.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06577-1"},{"key":"2025091923273187000_95.4.276.7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.06.018"},{"key":"2025091923273187000_95.4.276.8","doi-asserted-by":"publisher","DOI":"10.1067\/mhj.2002.123319"},{"key":"2025091923273187000_95.4.276.9","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(00)01207-8"},{"key":"2025091923273187000_95.4.276.10","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68929-0"},{"key":"2025091923273187000_95.4.276.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06887-8"},{"key":"2025091923273187000_95.4.276.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.084"},{"key":"2025091923273187000_95.4.276.13","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(00)00804-4"},{"key":"2025091923273187000_95.4.276.14","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.5.387"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.2008.146365","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T06:27:39Z","timestamp":1758349659000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.2008.146365"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2008,12,15]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2009,1,28]]},"published-print":{"date-parts":[[2009,2]]}},"alternative-id":["10.1136\/hrt.2008.146365"],"URL":"https:\/\/doi.org\/10.1136\/hrt.2008.146365","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2008,12,15]]}}}