Criteria for cardiac morbidity:
(1) acute myocardial infarction
(2) ventricular arrhythmia
(3) heart failure
(4) unstable angina
Findings on the ECG associated with a cardiac event within 90 days of a TIA:
(1) atrial fibrillation
(2) left ventricular hypertrophy
(3) heart rate > 80 beats per minute
(4) atrioventricular (AV) block
Other findings associated with increased cardiac morbidity:
(5) history of coronary artery disease
(6) systolic blood pressure < 140 mm Hg
|
Finding
|
Odds Ratio
|
95% CI
|
p value
|
|
atrial fibrillation
|
7.2
|
3.0 – 17.0
|
< 0.001
|
|
LV hypertrophy
|
4.5
|
2.1 – 9.7
|
< 0.001
|
|
heart rate
|
4.5
|
2.0 – 10.0
|
0.001
|
|
AV block
|
4.4
|
2.0 – 10.1
|
< 0.001
|
|
history CAD
|
3.7
|
1.6 – 8.0
|
0.001
|
|
systolic blood pressure
|
3.3
|
1.2 – 9.3
|
0.02
|
from Table 3, page 1439
Interpretation:
• A person with none of these findings has less than a 1% chance of short-term cardiac morbidity (based on Table 2, page 1439).
• The presence of 1 or more abnormalities is associated with a 4.2% chance of cardiac morbidity. The type and number of abnormalities determines the risk.
NOTE: While the relative risk for cardiac morbidity is 4 times greater if an abnormality is present, the overall risk is not enormous unless multiple risk factors are present.
