The American journal of cardiology
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The initial electrocardiogram is crucial in accurately selecting patients with chest pain for thrombolytic therapy. An electrocardiogram with a large amount of ST-segment elevation and depression is "visually alarming," and therefore, may influence the efficiency of patient treatment with thrombolytic therapy. It was hypothesized that the amount of ST-segment deviation present on the initial electrocardiogram was an important variable in determining the time to initiation of thrombolysis in the emergency department. ⋯ Regression analysis of multiple clinical variables revealed that ST-segment sum was the only variable that significantly influenced the time to thrombolysis (r = -0.42; p < 0.001). For patients treated in < or = 30 minutes, the average ST-segment sum was 21.1 +/- 13.5 vs 11.5 +/- 11.4 mm for those treated in > or = 60 minutes (p = 0.01). In 10 patients mistakenly treated with thrombolytic therapy, the electrocardiographic processes responsible for ST-segment elevation included the early repolarization variant, left ventricular hypertrophy, old anterior AMI with persistent ST-segment elevation, and conduction delay.(ABSTRACT TRUNCATED AT 250 WORDS)
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The amount of abdominal visceral adipose tissue measured by computed tomography is a critical correlate of the potentially "atherogenic" metabolic disturbances associated with abdominal obesity. In this study conducted in samples of 81 men and 70 women, data are presented on the anthropometric correlates of abdominal visceral adipose tissue accumulation and related cardiovascular disease risk factors (triglyceride and high-density lipoprotein cholesterol levels, fasting and postglucose insulin and glucose levels). Results indicate that the waist circumference and the abdominal sagittal diameter are better correlates of abdominal visceral adipose tissue accumulation than the commonly used waist-to-hip ratio (WHR). ⋯ When the samples were divided into quintiles of waist circumference, WHR or abdominal sagittal diameter, it was noted that increasing values of waist circumference and abdominal sagittal diameter were more consistently associated with increases in fasting and postglucose insulin levels than increasing values of WHR, especially in women. These findings suggest that the waist circumference or the abdominal sagittal diameter, rather than the WHR, should be used as indexes of abdominal visceral adipose tissue deposition and in the assessment of cardiovascular risk. It is suggested from these data that waist circumference values above approximately 100 cm, or abdominal sagittal diameter values > 25 cm are most likely to be associated with potentially "atherogenic" metabolic disturbances.