Prognosis following acute myocardial infarction in patients with ECG evidence of left ventricular hypertrophy prior to infarction.

This study was designed to determine the relationship between prognosis after myocardial infarction (MI) and left ventricular hypertrophy (LVH). Left ventricular hypertrophy diagnosed by electrocardiography according to the criteria of Sokolow and Lyon was noted in 57 of 223 patients (25.6%) on the pre-MI electrocardiogram (ECG), in 11.2% on an early post-MI ECG, and in 11.3% on the discharge ECG. In-hospital and 1-year postdischarge mortalities were significantly greater in patients with LVH noted on pre-MI ECG than in patients without prior LVH. There was no relationship between the presence of LVH on early post-MI ECGs and in-hospital or postdischarge 1-year mortality. Multivariate analysis revealed that evidence of LVH on a pre-MI ECG and acute congestive heart failure were independent predictors of cardiac death within 1 year of MI in patients over 70 years old. It is concluded that in patients over 70 years of age, the presence of LVH on a pre-MI ECG is a reliable predictor of post-MI prognosis.