Abstract
The clinical course of patients with non-Q wave myocardial infarction (MI) has been the subject of interest. Natural history studies have suggested that non-Q wave MI is associated with less necrosis, better left ventricular function and a lower in-hospital mortality compared with Q-wave MI. Despite this more favourable initial prognosis, long-term survival for patients with non-Q wave MI appears to be similar to or even less than that in patients with Q-wave MI [1–26]. The relatively high mortality rate of patients with non-Q wave MI seems to be related to unstable angina or subsequent recurrent MI in the same area [1,4,6–8, 16, 19, 23–26] and may be preventable if recurrent MI can be averted with revascularization. These findings have understandably led some to recommend more agressive evaluation and treatment strategies for survivors of non-Q wave MI, particularly since the benefit of prophylactic pharmacologic treatment is unproven in this subset of patients [27–30].
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