scholarly journals Two types of humoral response in acute myocardial infraction

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
E Konstantinova ◽  
A Bogdanova ◽  
M Gilyarov ◽  
A Sergeev ◽  
A Svet ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Growth Factors ◽  
Humoral Response ◽  
Normal Serum ◽  
Gm Csf ◽  
Funding Sources ◽  
Cytokines And Chemokines ◽  
Cardiology Department ◽  
Significant Difference ◽  
Myocardial Infraction

Abstract Background Atherothrombosis and myocardial infarction are accompanied by the development of an inflammatory reaction. The severity of the immune reaction and its role in the acute myocardial infarction (AMI) remain contradictory to date. Purpose The objective of this study was to analyze 39 cytokines and chemokines in the serum of patients hospitalized with AMI compared to the healthy volunteers. Methods All patients included in the study were COVID-19 negative. Patients' blood was collected within 1–2 days after hospitalization in the cardiology department. Cytokine and chemokine detection in the serum of patients (n=20) and donors (n=20) was performed using a 39-plex set of cytometric beads. Results Among all factors analyzed TGFa, IL-17A, IL-1b, 3, 5, 9 were not detected both in patient and donor sera. Three groups of factors were identified in the normal serum: housekeeping chemokines and vascular factors (F1) ranged from 1000 to 22000 pg/mL (Fig. a); sentinel innate immunity factors F2 (Fig. b), 30–200 pg/mL; and acute phase factors F3 (Fig. c, d), 0–30 pg/mL, detected only in 0–30% of donors but in all AMI patients. Severe imbalance was found in AMI sera at all three levels including chemokine, growth factors, and cytokines. Among AMI patients 65% (Gr1) demonstrated 2–4 times increased level (Fig. a, grey brackets) while 35% (Gr2) had a decreased level of F1 factors in a comparison with donor sera. There was not significant difference between clinical features of the patients in Gr1 and Gr2. GRO, PDGF-AA, and sCD40L levels decreased 35, 15, and 10 times accordingly. Gr1 and Gr2 also differed in F2 and some F3 concentrations: Gr1 had 3–5 times increased level of multiple factors (Fig, b), among them – IL-6, IL-8, and IL-10 were increased 5, 6, and 14 times. At the same time Gr2 had a normal level of these factors (Fig, b, blue brackets). Finally, multiple cytokines and growth factors F3 were significantly increased in both AMI groups (Fig, b, d, red brackets). Of note, IL-12, IFN-g, IL-15, GM-CSF, FLT-3T were increased 8, 6, 5, 5, 5 times accordingly in pooled Gr1+Gr2. There were no correlations found between cytokine profiles in Gr1 and Gr2 and their clinical parameters. Conclusions Two types of humoral response in AMI patients were identified which differed in the levels of GRO, PDGF-AA, and sCD40L. IL-6 as well as TNF-a can not serve as master cytokines because their levels were increased only in Gr1 patients. These data show that Th1 cytokine increase is specific for AMI. Further studies are needed to identify groups of patients who may be exposed to new therapeutic targets. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Prevalence and main causes of myocardial infarction type 2 in the structure of in-hospital mortality

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
D Oblavatsky ◽  
S Boldueva
Keyword(s):  
Myocardial Infarction ◽  
Causes Of Death ◽  
Surgical Patients ◽  
Control Group ◽  
Type Ii ◽  
Funding Sources ◽  
Cardiology Department ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Purpose the assessment of the proportion of myocardial infarction (MI) type 2 in the structure of mortality in a multidisciplinary hospital Material and methods. A retrospective study was made of 1,574 autopsy protocols carried out in a multidisciplinary hospital in the period from 01.01.10 to 31.12.16, of which a group with postmortem type II MI was identified. The control group was composed of persons who died from proven atherothrombotic type 1 MI Results. In 360 cases (22.87%), the cause of death was MI. Of these, 137 cases were due to type 2 MI. The ratio of men and women was the same. Type 2 MI more often developed in elderly (48.2%) and senile (34.3%) ages; the average age of patients with type 2 MI was 71.7 ± years (68.2 ± 3 years among men and 75.3 ± 4 years among women p <0.05), which did not differ from the group with fatal type 1 MI. The main causes of death in type 2 MI were tachysystolic arrhythmias - 59.12% of cases, severe hypoxia of any etiology - 35.04%. The absence of significant stenoses of coronary artery (CA) is significantly more common in type 2 MI, and multivessel disease - in type 1 MI. In the group of patients with type 1 MI, 67.29% had multivessel lesions (Table 1). When comparing mortality in different departments of a multidisciplinary hospital, it turned out that only 29.2% of patients with type 2 MI were initially hospitalized in the cardiology department; 45.3% of patients - therapeutic, 25.5% of patients – surgical. Conclusion. Nearly one in four patients dies as a result of MI, with more than 1/3 of fatal MIs occurring in type 2 MI. The main reasons for the development of type 2 MI: tachysystolic arrhyhythmias - 59.12%, hypoxia of various origins - 35.04%, sepsis - 2.2%. 25% of fatal type 2 MIs occurred in surgical patients. Table 1. CA in type 1 and 2 MISign1 type MI (n = 223)2 type MI (n = 137)рNo significant stenosis2,24%32,85%0,001Single CA significant stenosis8.07%12,41%0,1932-CA significant stenosis23,3%23,36%0,272Multivessel stenosis66,4%31,38%0,005Occlusion of at least one СА48,9%4,38%0,001

scholarly journals Protective Effect of Ipomoea biloba on Myocardial Antioxidant Status in Isoproterenol Induced Myocardial Infarction Male Albino Rats

2021 ◽  
pp. 36-45
Author(s):  
R. Vallipriya ◽  
M. Shabana Begum
Keyword(s):  
Myocardial Infarction ◽  
Vitamin C ◽  
Protective Effect ◽  
Leaf Extract ◽  
Oral Treatment ◽  
Albino Rats ◽  
Heart Homogenate ◽  
Significant Difference ◽  
Myocardial Infraction ◽  
Ethanolic Leaf Extract

The protective effect of ethanolic leaf extract of Ipomoea biloba in isoproterenol (ISO)-induced cardiotoxicity and the antioxidant activity involved in this protection were investigated in rats. Myocardial infraction was produced in rats with 20 mg/kg b.wt of ISO administered subcutaneously twice at an interval of 24 h. Effect of EEIB oral treatment for 28 days at two doses (100 mg and 200 mg/kg body weight) was evaluated against ISO – induced cardiac necrosis. Level of enzymatic (SOD, CAT, GPx and GST), non-enzymatic (GSH, Vitamin C and E) and of membrane bound ATPases (Na+K+ATPase, Mg2+ATPase and Ca2+ATPase) were assayed in heart homogenate. Significant myocardial infarction, depletion of endogenous antioxidants enzymatic and non-enzymatic were observed in ISO-treated animals when compared with the normal animals. Rats induced with ISO, showed a significant (P<0.05), decrease in the activities of GSH, Vitamin C and Eon comparison with normal rats.   EEIB elicited a significant cardioprotective activity by elevated the levels of GSH, SOD, CAT, GPx and GR. A significant decrease in the activity of Na+/K+ ATPase and a corresponding increase in the activities of Ca2+ ATPase and Mg2+ ATPase were observed in isoproterenol induced rats when compared to normal control rats. Pretreatment with EEIB was able to efficiently prevent the increase in activity of Mg2+ ATPase and maintain the activities of Na+ /K+ ATPase and Ca2+ ATPase at near normality. There is no significant difference between the control and plant alone treated rats. The aim of this investigation is to evaluate the antioxidant effects on the main cardioprotective activity of ethanolic leaf extract Ipomoea biloba.

scholarly journals Assessment of Multiple Cardiac Biomarkers in Acute STEMI Patients without Clinical Manifestation of Heart Failure in NICVD

2016 ◽  
Vol 4 (2) ◽  
pp. 55-60
Author(s):  
Syeda Shahina Subhan ◽  
Nasir Uddin Mithu ◽  
Md Rezwanur Rahman ◽  
Sharifun Nahar ◽  
Muhsina Abdullah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Clinical Symptoms ◽  
Normal Serum ◽  
Cardiac Biomarkers ◽  
Age Group ◽  
Acute Stemi ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
Group B

Background: In patients with acute coronary syndrome (ACS), Cardiac Troponin I (cTnI) elevation is indicative of myocardial damage. After acute myocardial infarction (AMI), level of Pro-BNP rises rapidly during the first 24 hours and tends to stabilize thereafter.Objective: The present study tried to explore the pattern of multiple cardiac biomarkers (cTnI, CK-MB, Pro-BNP, SGOT and LDH) in newly diagnosed acute ST-elevation myocardial infarction (STEMI) patients without clinical symptoms of heart failure.Materials and method: This was a prospective study. Total 82 acute STEMI patients were recruited purposively from National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh, within 24 hours of symptoms having normal serum creatinine level. cTnI and pro-BNP elevation were defined >1mg/mL and >125 pg/mL respectively. The study population was sub grouped according to age: group A (<40 years), group B (40-50 years), group C (>51-60 years) and group D (>60 years).Results: The mean±SD age of patients was 53.3±11.6 years and 42.70% population belonged to relatively younger age group (group B). Smoking was found on the top of the list (73.20%) as a risk factor. There was no difference among the groups regarding atherosclerotic marker and no other cardiac markers except pro-BNP. Only Pro-BNP (pg/mL) showed gradual and progressive increment with increasing age. No significant difference was observed between CRP positive and negative groups in different age groups (cut off value <6mg/dL). Group B (40-50 years) seems to be the most vulnerable as the anterior and the extensive anterior myocardial infarctions (worst prognosis) were highest in this group.Conclusion: Worst prognosis is associated with increased age and raised pro-BNP level.Delta Med Col J. Jul 2016 4(2): 55-60

The main etiological reasons of fatal type 2 myocardial infarction

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
I Leonova ◽  
D Oblavatsky ◽  
S Boldueva
Keyword(s):  
Myocardial Infarction ◽  
Causes Of Death ◽  
Control Group ◽  
Significant Stenosis ◽  
Funding Sources ◽  
Cardiology Department ◽  
Sign Type ◽  
Funding Acknowledgements

Abstract Funding Acknowledgements Type of funding sources: None. Purpose the assessment of the proportion of myocardial infarction (MI) type 2 in the structure of mortality in a multidisciplinary hospital Material and methods. A retrospective study was made of 1,574 autopsy protocols carried out in a multidisciplinary hospital in the period from 01.01.10 to 31.12.16, of which a group with postmortem type II MI was identified. The control group was composed of persons who died from proven atherothrombotic type 1 MI Results. In 360 cases (22.87%), the cause of death was MI. Of these, 137 cases were due to type 2 MI. The ratio of men and women was the same. Type 2 MI more often developed in elderly (48.2%) and senile (34.3%) ages; the average age of patients with type 2 MI was 71.7 ± years (68.2 ± 3 years among men and 75.3 ± 4 years among women p &lt;0.05), which did not differ from the group with fatal type 1 MI. The main causes of death in type 2 MI were tachysystolic arrhythmias - 59.12% of cases, severe hypoxia of any etiology - 35.04%. The absence of significant stenoses of coronary artery (CA) is significantly more common in type 2 MI, and multivessel disease - in type 1 MI. In the group of patients with type 1 MI, 67.29% had multivessel lesions (Table 1). When comparing mortality in different departments of a multidisciplinary hospital, it turned out that only 29.2% of patients with type 2 MI were initially hospitalized in the cardiology department; 45.3% of patients - therapeutic, 25.5% of patients – surgical. Conclusion. Nearly one in four patients die as a result of MI, with more than 1/3 of fatal MIs occurring in type 2 MI. The main reasons for the development of type 2 MI: tachysystolic arrhythmias - 59.12%, hypoxia of various origins - 35.04%, sepsis - 2.2%. 25% of fatal type 2 MIs occurred in surgical patients. Table 1. CA in type 1 and 2 MI Sign Type 1 MY n = 223 Type 2 MY n = 137 p No significant stenosis 2,24% 32,85% 0,001 Single CA significant stenosis 8,07% 12,41% 0,193 2-CA significant stenosis 23,3% 23,36% 0,272 Multivessel stenosis 66,4% 31,38% 0,005 Occlusion of at least one CA 48,9% 4,38% 0,001

Myocardial infarction in young adults: are the risk profile and mortality outcomes different from older patients?

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
J Borges-Rosa ◽  
GM Campos ◽  
S Martinho ◽  
JL Almeida ◽  
V Goncalves ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Young Patients ◽  
Risk Profile ◽  
Premature Coronary Artery Disease ◽  
Age Cohorts ◽  
Obstructive Disease ◽  
Funding Sources ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Artery Disease

Abstract Funding Acknowledgements Type of funding sources: None. Introduction The incidence of acute myocardial infarction (AMI) among young patients is increasing. The YOUNG-MI Registry reported that those under 40 years had similar risk profiles and outcomes compared to those aged 41 to 50. We aimed to evaluate cardiovascular risk factors and mortality outcomes in two age cohorts from southern European. Methods We retrospectively evaluated 4758 patients admitted to our coronary intensive care unit between 2004 and 2017 with AMI. We only included patients &lt;60 years in two subgroups: cohort A &lt; 50 years and cohort B 50-60 years.  Results From the 1233 patients included (mean age 50.5 ± 6.5 years, 82.2% male), 53% had STEMI. Cohort B had higher rates of hypertension (59.8 vs. 42.9%, p &lt; 0.001), diabetes (41.8 vs. 28.9%, p &lt; 0.001), and dyslipidemia (59.4 vs. 46.4%, p &lt; 0.001), while cohort A had higher rates of familial premature coronary artery disease (20.9 vs. 13.2%, p &lt; 0.001) and smoking habits (54.4 vs. 40.0%, p &lt; 0.001). Regarding coronary angiography, cohort B had higher rates of obstructive disease in each epicardial artery, except for left main involvement and non-obstructive disease (Fig. 1). Cohort A had lower all-cause mortality rates at the index hospitalization (1.3 vs. 3.2%, p = 0.045), 6-months (2.9 vs.5.4, p = 0.038), 1-year (3.1 vs. 6.3%, p = 0.014), and 3-years (3.6 vs 8.4, p = 0.001). After multivariable adjustment, we found no relationship between age cohorts and all-cause mortality for any follow-up timing: HR 1.57 (95% CI 0.56-4.37), 1.37 (95% CI 0.50-3.74), and 0.92 (95% CI 0.35-2.39) at 6-months, 1-year, and 3-years, respectively. Conclusion Among patients who suffer AMI, those under 50 years old have a different risk profile, compared to the 50-60 years cohort. However, there is no significant difference in all-cause mortality. Abstract Figure.

scholarly journals Sex and age differences in patients with a working diagnosis of myocardial infarction with non-obstructive coronary arteries (MINOCA): presentation and outcome

2021 ◽  
Vol 22 (Supplement_2) ◽  
Author(s):  
MGL Williams ◽  
A Dastidar ◽  
K Liang ◽  
TW Johnson ◽  
A Baritussio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Age Differences ◽  
Coronary Arteries ◽  
Risk Of Death ◽  
Funding Sources ◽  
Tertiary Centre ◽  
Significant Difference ◽  
All Cause Mortality ◽  
The Impact ◽  
Sex And Age Differences

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Rosetrees Trust James Tudor Foundation Background Myocardial infarction with non-obstructive coronary arteries (MINOCA) is an increasingly recognised working diagnosis. Sex and age differences in MINOCA are not well understood. Purpose  This study aims to evaluate the impact of sex and age in patients with MINOCA due to ischaemic and non-ischaemic causes on clinical presentation and outcome. Methods and Results Consecutive patients with a working diagnosis of MINOCA (n = 719) from a single tertiary centre who underwent comprehensive cardiovascular magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) were followed prospectively. The primary endpoint was all-cause mortality.  CMR was performed at a median time of 30 days after presentation and identified a diagnosis in 74% of patients. Men were more likely to have a non-ischaemic cause on CMR (55% v. 41%, p &lt; 0.001) and less likely to have a normal/non-specific scan (21% v. 32%, p = 0.001, figure 1).  All-cause mortality was 9.5% over a median follow up of 4.9 years, with no significant difference between sexes (8.7% versus 10.1% p = 0.456).  Age group (HR 1.61, p &lt; 0.001) and LVEF (HR 0.98, p = 0.020) were independent predictors of mortality. Men aged &gt;60 years with a non-ischaemic aetiology on their CMR were at higher risk of death than women with non-ischaemic causes &gt;60 years (p = 0.003, figure 2). Conclusions There is no difference in all-cause mortality between sexes in MINOCA but increasing age is the most important predictor of mortality in both sexes.

STUDIES ON SULFATION FACTOR (SF) ACTIVITY OF HUMAN SERUM

1960 ◽  
Vol XXXV (III) ◽  
pp. 381-396 ◽  
Author(s):  
Sven Almqvist
Keyword(s):  
Human Serum ◽  
Normal Serum ◽  
Treatment Level ◽  
Response Curves ◽  
Normal Children ◽  
Significant Difference ◽  
Human Sera ◽  
Normal Humans ◽  
Pre Treatment ◽  
Dose Levels

ABSTRACT The sulfation factor (SF) activity of human sera has been estimated using a modification of the method of Daughaday et al. (1959). Each assay was statistically evaluated. The method had a mean precision of 0.14 and, used as an assay of GH of human serum, a sensitivity in three pituitary dwarfs of 0.1 to 0.6 μg of HGH/ml of serum. SF activity was found at all ages between 1 month and 75 years. There was a significantly lower mean SF activity below the age of half a year. Three cases of pituitary dwarfism had significantly low SF activities of sera. There was no significant difference between the SF activities of sera from untreated pituitary dwarfs and the sera from normal children below half a year of age. Dose-response curves with large volumes of sera from pituitary dwarfs and small volumes of sera from normal humans had the same slopes. Four mg of HGH prepared according to the method of Li & Papkoff (1956) resulted in a normal serum SF activity in each of the three dwarfs. A significant (P < 0.01) linear relationship was found between the concentration of SF activity of sera from these subjects and the logarithm of the dose of HGH given with dose levels of 1, 2 and 4 mg daily for three days. The decline of serum SF activity to the pre-treatment level following HGH in one dwarf suggested a half life not different from that indicated by others for growth hormone.

scholarly journals Detection of Myocardial Infarction Using ECG and Multi-Scale Feature Concatenate

Sensors ◽  
2021 ◽  
Vol 21 (5) ◽  
pp. 1906
Author(s):  
Jia-Zheng Jian ◽  
Tzong-Rong Ger ◽  
Han-Hua Lai ◽  
Chi-Ming Ku ◽  
Chiung-An Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Network Structure ◽  
Class Imbalance ◽  
Class Imbalance Problem ◽  
Multi Scale ◽  
Imbalance Problem ◽  
Average Accuracy ◽  
Significant Difference ◽  
Electrocardiogram Ecg

Diverse computer-aided diagnosis systems based on convolutional neural networks were applied to automate the detection of myocardial infarction (MI) found in electrocardiogram (ECG) for early diagnosis and prevention. However, issues, particularly overfitting and underfitting, were not being taken into account. In other words, it is unclear whether the network structure is too simple or complex. Toward this end, the proposed models were developed by starting with the simplest structure: a multi-lead features-concatenate narrow network (N-Net) in which only two convolutional layers were included in each lead branch. Additionally, multi-scale features-concatenate networks (MSN-Net) were also implemented where larger features were being extracted through pooling the signals. The best structure was obtained via tuning both the number of filters in the convolutional layers and the number of inputting signal scales. As a result, the N-Net reached a 95.76% accuracy in the MI detection task, whereas the MSN-Net reached an accuracy of 61.82% in the MI locating task. Both networks give a higher average accuracy and a significant difference of p < 0.001 evaluated by the U test compared with the state-of-the-art. The models are also smaller in size thus are suitable to fit in wearable devices for offline monitoring. In conclusion, testing throughout the simple and complex network structure is indispensable. However, the way of dealing with the class imbalance problem and the quality of the extracted features are yet to be discussed.

scholarly journals Prasugrel versus ticagrelor in patients with myocardial infarction undergoing percutaneous coronary intervention

Heart ◽  
2021 ◽  
pp. heartjnl-2020-318694
Author(s):  
Dimitrios Venetsanos ◽  
Erik Träff ◽  
David Erlinge ◽  
Emil Hagström ◽  
Johan Nilsson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Similar Efficacy ◽  
Efficacy And Safety ◽  
Adjusted Risk ◽  
Cerebrovascular Events ◽  
Percutaneous Coronary ◽  
Significant Difference ◽  
Evidence Based Care

ObjectiveThe comparative efficacy and safety of prasugrel and ticagrelor in patients with myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) remain unclear. We aimed to investigate the association of treatment with clinical outcomes.MethodsIn the SWEDEHEART (Swedish Web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies) registry, all patients with MI treated with PCI and discharged on prasugrel or ticagrelor from 2010 to 2016 were included. Outcomes were 1-year major adverse cardiac and cerebrovascular events (MACCE, death, MI or stroke), individual components and bleeding. Multivariable adjustment, inverse probability of treatment weighting (IPTW) and propensity score matching (PSM) were used to adjust for confounders.ResultsWe included 37 990 patients, 2073 in the prasugrel group and 35 917 in the ticagrelor group. Patients in the prasugrel group were younger, more often admitted with ST elevation MI and more likely to have diabetes. Six to twelve months after discharge, 20% of patients in each group discontinued the P2Y12 receptor inhibitor they received at discharge. The risk for MACCE did not significantly differ between prasugrel-treated and ticagrelor-treated patients (adjusted HR 1.03, 95% CI 0.86 to 1.24). We found no significant difference in the adjusted risk for death, recurrent MI or stroke alone between the two treatments. There was no significant difference in the risk for bleeding with prasugrel versus ticagrelor (2.5% vs 3.2%, adjusted HR 0.92, 95% CI 0.69 to 1.22). IPTW and PSM analyses confirmed the results.ConclusionIn patients with MI treated with PCI, prasugrel and ticagrelor were associated with similar efficacy and safety during 1-year follow-up.

scholarly journals Prospective associations between ECG abnormalities and death or myocardial infarction in a cohort of 980 employed, middle-aged Swedish men

2020 ◽  
Vol 72 (1) ◽  
Author(s):  
Lennart Dimberg ◽  
Bo Eriksson ◽  
Per Enqvist
Keyword(s):  
Myocardial Infarction ◽  
Health Examination ◽  
Individual Level ◽  
Increased Risk ◽  
Significant Difference ◽  
Ethical Approval ◽  
Independent Association ◽  
Repeat Examination ◽  
Normal Ecgs ◽  
Ecg Abnormalities

Abstract Background In 1993, 1000 randomly selected employed Swedish men aged 45–50 years were invited to a nurse-led health examination with a survey on life style, fasting lab tests, and a 12-lead ECG. A repeat examination was offered in 1998. The ECGs were classified according to the Minnesota Code. Upon ethical approval, endpoints in terms of MI and death over 25 years were collected from Swedish national registers with the purpose of analyzing the independent association of ECG abnormalities as risk factors for myocardial infarction and death. Results Seventy-nine of 977 participants had at least one ECG abnormality 1993 or 1998. One hundred participants had a first MI over the 25 years. Odds ratio for having an MI in the group that had one or more ECG abnormality compared with the group with two normal ECGs was estimated to 3.16. 95%CI (1.74; 5.73), p value 0.0001. One hundred fifty-seven participants had died before 2019. For death, similarly no statistically significant difference was shown, OR 1.52, 95%CI (0.83; 2.76). Conclusions Our study suggests that presence of ST- and R-wave changes is associated with an independent 3–4-fold increased risk of MI after 25 years follow-up, but not of death. A 12-lead resting ECG should be included in any MI risk calculation on an individual level.

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