{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:48:09Z","timestamp":1774352889288,"version":"3.50.1"},"reference-count":31,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1998,2,10]]},"abstract":"<jats:p>\n            <jats:italic>Background<\/jats:italic>\n            \u2014Although the stratification of patients with myocardial infarction into ECG subsets based on the presence or absence of new Q waves has important clinical and prognostic utility, systematic evaluation of the impact of thrombolytic therapy on the subsequent development and prognosis of non\u2013Q-wave infarction has been limited to date.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Methods and Results<\/jats:italic>\n            \u2014We examined 12-lead ECG, coronary anatomy, left ventricular function, and mortality among 2046 patients with ST-segment elevation infarction from the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries angiographic subset to gain further insight into the pathophysiology and prognosis of Q- versus non\u2013Q-wave infarction in the thrombolytic era. Non\u2013Q-wave infarction developed in 409 patients (20%) after thrombolytic therapy. Compared with Q-wave patients, non\u2013Q-wave patients were more likely to present with lesser ST-segment elevation in a nonanterior location. The infarct-related artery in non\u2013Q-wave patients was more likely to be nonanterior (67% versus 58%,\n            <jats:italic>P<\/jats:italic>\n            =.012) and distally located (33% versus 39%,\n            <jats:italic>P<\/jats:italic>\n            =.021). Early (90-minute, 77% versus 65%,\n            <jats:italic>P<\/jats:italic>\n            =.001) and complete (54% versus 44%,\n            <jats:italic>P<\/jats:italic>\n            &lt;.001) infarct-related artery patency was greater among the non\u2013Q-wave group. Non\u2013Q-wave patients had better global (ejection fraction, 66% versus 57%;\n            <jats:italic>P<\/jats:italic>\n            &lt;.0001) and regional left ventricular function (10 versus 24 abnormal chords,\n            <jats:italic>P<\/jats:italic>\n            =.0001). In-hospital, 30-day, 1-year, and 2-year (6.3% versus 10.1%,\n            <jats:italic>P<\/jats:italic>\n            =.02) mortality rates were lower among non\u2013Q-wave patients.\n          <\/jats:p>\n          <jats:p>\n            <jats:italic>Conclusions<\/jats:italic>\n            \u2014The excellent prognosis among the subgroup of patients who develop non\u2013Q-wave infarction after thrombolysis is related to early, complete, and sustained infarct-related artery patency with resultant limitation of left ventricular infarction and dysfunction.\n          <\/jats:p>","DOI":"10.1161\/01.cir.97.5.444","type":"journal-article","created":{"date-parts":[[2012,6,12]],"date-time":"2012-06-12T00:41:02Z","timestamp":1339461662000},"page":"444-450","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":53,"title":["Non\u2013Q-Wave Versus Q-Wave Myocardial Infarction After Thrombolytic Therapy"],"prefix":"10.1161","volume":"97","author":[{"given":"Shaun G.","family":"Goodman","sequence":"first","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anatoly","family":"Langer","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Allan M.","family":"Ross","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nancy M.","family":"Wildermann","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Barbagelata","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elena B.","family":"Sgarbossa","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Galen S.","family":"Wagner","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher B.","family":"Granger","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert M.","family":"Califf","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Topol","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maarten L.","family":"Simoons","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul W.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"From The Terrence Donnelly Heart Centre, Division of Cardiology, St Michael\u2019s Hospital, University of Toronto, Toronto, Canada (S.G.G., A.L.); Duke University Medical Center, Durham, NC (N.M.W., G.S.W., C.B.G., R.M.C.); George Washington University Medical Center, Washington, DC (A.M.R.); Favaloro Institute, Buenos Aires, Argentina (A.B.); Cleveland Clinic Foundation, Cleveland, Ohio (E.B.S., E.J.T.); Thorax Center, Rotterdam, The Netherlands (M.L.S.); and Department of Medicine, University of..."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"e_1_3_2_1_2","first-page":"1","volume":"13","year":"1988","unstructured":"Gibson RS. 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New York NY: Elsevier; 1991:284\u2013307."},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/0140-6736(93)92186-W"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9149(99)80122-2"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1161\/circ.88.2.8339405"}],"container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/01.CIR.97.5.444","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T16:39:51Z","timestamp":1715531991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.97.5.444"}},"subtitle":["Angiographic and Prognostic Insights From the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries\u2013I Angiographic Substudy"],"short-title":[],"issued":{"date-parts":[[1998,2,10]]},"references-count":31,"journal-issue":{"issue":"5","published-print":{"date-parts":[[1998,2,10]]}},"alternative-id":["10.1161\/01.CIR.97.5.444"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.97.5.444","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1998,2,10]]},"assertion":[{"value":"1997-06-05","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"1997-10-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"1998-02-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}