Hemodynamic and prognostic findings in patients with transmural and nontransmural infarction.

Abstract

One hundred and eleven patients with transmural (TMI) and 49 with nontransmural myocardial infarction (NTMI) underwent hemodynamic investigation within 24 hours of onset of symptoms. Patients with NTMI were subdivided into those with ST-segment or T-wave changes alone with a normal QRS complex (NTMI-A) and a group with QRS abnormalities that did not satisfy the criteria for TMI (NTMI-B). Those with TMI had a significantly higher peak creatine phosphokinase (CPK) than those with NTMI: 840 plus or minus 99 and 336 plus or minus 69, respectively, P smaller than 0.05. There was not difference in peak CPK between those with NTMI-A and B. The incidence of arrhythmias and cardiac failure, and routine hemodynamic findings except for left ventricular filling pressure were similar in those with TMI and NTMI. There was not significant difference in in-hospital mortality between those with TMI (22%) and NTMI (33%). There was however a significant difference in in-hospital mortality between those with NTMI-A (0%) and NTMI-B (27%, P smaller than 0.05). The late mortality in those surviving their initial hospitalization was also not different between those with TMI (18%) and NTMI (19%) during a mean follow-up period of 20.2 months. In contrast to the in-hospital mortality those with NTMI-A had a late mortality similar to those with NTMI-B and those with TMI.