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Correspondence
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Volume 335:131-133 July 11, 1996 Number 2
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Electrocardiographic Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle-Branch Block

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 by Wellens, H. J.J.
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 by Sgarbossa, E. B.
-PubMed Citation
To the Editor: Sgarbossa and colleagues (Feb. 22 issue)1 use data from the GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) trial to suggest improvements in the accuracy of the electrocardiographic diagnosis of acute myocardial infarction in patients with left bundle-branch block and acute chest pain. The predictive values they report (Table 5 of the article), however, depend on a 50 percent prevalence of myocardial infarction in this group, which is artificially high. Predictive values are markedly dependent on prevalence, and in actual clinical practice, it is unlikely that the new electrocardiographic criteria would be . . . [Full Text of this Article]

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