Corrections


CORRECTIONS

Diabetes Mellitus and Outcome After Primary Coronary
Angioplasty for Acute Myocardial Infarction: Lessons
from the GUSTO-IIb Angioplasty Substudy. J Am Coll
Cardiol 2000;35:1502–12. There is an error in Figure 2

on page 1510. The horizontal axis should have read as
follows: Time to Death (Days). The corrected Figure 2
appears below.

Detection of Myocardial Ischemia Using Additional Left
Posterior and Right Precordial Leads During Exercise
Electrocardiography. Abstract—Cardiac Function and
Heart Failure, Session 1139 –121. J Am Coll Cardiol
2000;35:210A. This abstract was presented at the 49th
Annual Scientific Session of the American College of
Cardiology, Anaheim, California. The first author of this
abstract was incorrectly listed as “Vijendra Swamp.” The
first author’s correct name is “Vijendra Swarup.” In addi-
tion, the first sentence in the Conclusions should have read
as follows: The addition of right precordial and left posterior
leads to the standard 12 lead ECG significantly improves
the sensitivity of the exercise ECG for the diagnosis of
myocardial ischemia. We regret these printing errors. The
corrected abstract appears below:
1139-121
Detection of Myocardial Ischemia Using Additional Left Posterior and Right
Precordial Leads During Exercise Electrocardiography
Vijendra Swarup, Neal Skop, Joel S. Raichlen, Thomas Jefferson University,
Philadelphia, Pennsylvania, USA

Background: Although stress electrocardiography (ECG) is less expensive than
imaging stress studies, it is relatively insensitive for detecting myocardial
ischemia. We examined the value of adding two right sided (RV3, RV4) and two
left posterior (V8, V9) leads (16 lead ECG) to improve the sensitivity of exercise
ECG for detecting myocardial ischemia.

Methods: We prospectively studied 229 patients (141 men and 88 women)
with a mean age of 56 6 22 who were undergoing nuclear exercise stress
testing. 49% were hypertensive, 18% diabetic, 48% hypercholesterolemic, 20%
smoked and 45% had a family history of premature coronary artery disease
(CAD); 32% had known CAD (prior infarction or revascularization).

Results: Patients exercised 8.8 6 6 minutes achieving an average heart
rate of 151 bpm with 79.5% achieving their target heart rate. Ischemia
was present in 38 patients (16.6%) as evidenced by at least one reversible
perfusion defect. There was evidence of myocardial ischemia on the standard
12 lead ECG in 34 patients (14.8%). An additional 12 patients met criteria for
ischemia on the 16 lead ECG. The 16 lead ECG increased the sensitivity of the
12 lead ECG from 41.9% to 65.1% (p , 0.001) with no reduction in specificity
(91.4% versus 90.3%). The 16 lead ECG improved the sensitivity for detecting
ischemia in women for 42.8% to 71.4%, in patients with known CAD from 32.0%
to 57.1% and in patients who did not achieve their target heart from 41.6% to
58.3%.

Conclusion: The addition of right precordial and left posterior leads to the
standard 12 lead ECG significantly improves the sensitivity of the exercise ECG
for the diagnosis of myocardial ischemia.

Figure 2. Kaplan-Meier curves depicting the estimated survival for diabetic and nondiabetic patients within 12 months of follow-up after (Re)MI. (Re)MI
5 reinfarction.

Journal of the American College of Cardiology Vol. 36, No. 2, 2000
© 2000 by the American College of Cardiology ISSN 0735-1097/00/$20.00
Published by Elsevier Science Inc.