| Objective:To understand the clinical characteristics of acute ST-segment elevation myocardial infarction with ischemic J waves in acute myocardial infarction super nasty phase and evaluate the clinical value of ischemic J wave on recent prognosis of acute myocardial infarctionMethod:The 88 patients with acute ST-segment elevation myocardial infarction and in linical pathways are selected from the Cardiovascular Disease Treatment Center of the First Clinical Hospital of Jilin University from April 2010 to January 2011, including 65 males,23 females, age range from 27 to 89 years old, mean age (57.68±13.21) years. Whether the results shown by ECG J wave or not, the patients were divided into J- wave groups and non-J- wave groups.we will compare the general clinical condition between the two groups,and statistically analyze the relativity between ischemic J wave and infarction wall, infarct-related coronary artery, the number of coronary artery lesions and occurrence of ventricular arrhythmia.Results:1.The average onset time of J-wave group was (2.03±0.98) hours, the average onset time of non- J-wave group was (2.40±0.71) hours,so the onset time of J-wave group was shorter than the control group(t=-2.341,p=0.022); The average onset age of J-wave group was (61.00±13.45) years old, the average onset age of non- J-wave group was (54.65±12.38) years old,so the onset age of J-wave group was older than the control group((t=2.306,p=0.024);J wave group and the non-J-wave group in the aspects of history of hypertension, history of diabetes, impaired fasting glucose tolerance, smoking, total cholesterol, low-density lipoprotein cholesterol, coronary artery dominant distribution, coronary single vessel lesions and coronary artery double-vessel lesions showed no statistical significance(p>0.05).2.The highest value of cardiac troponin I that was within 24 hours after admission in J wave group was higher than the non-J wave group, the difference was statistically significant (t=3.083, p= 0.030).3. The incidence of the right coronary artery as culprit artery in J wave group was significantly higher than non-J wave group and the difference was statistically significant (X2=6.555, p=0.030); patients with acute inferior myocardial infarction occurred in J wave group are more than non-J wave group,the difference was also statistically significant (X2=4.443, p=0.035).4. The incidence of ventricular arrhythmias of J wave group was obviouly higher than the non-J wave, the difference was statistically significant (X2= 15.660, p 0.000), and varied forms, the most common formation is paroxysmal ventricular tachycardia (30.0%), followed by ventricular fibrillation (12.5%).5. The three coronary artery disease of J wave group was more than non-J wave group, the difference was statistically significant (X2=8.770,p=0.003), and in three cases of left main disease.Conclusion:The onset time of the patients of acute ST-segment elevation myocardial infarction with J wave was earlier and the onset age was older; the highest value of troponin I within 24 hours after admission was higher,indicating the larger infarct size and poor prognosis;In addition,ischemic J wave often occurs in the hyperacute stage of acute myocardial infarction, it often happens in inferior ventricular wall, more involves right coronary artery,higher incidence of three diseases,and the incidence of ventricular arrhythmia significantly increases, and the J wave forms varied, the most common is paroxysmal ventricular tachycardia, followed by ventricular fibrillation. In summary, ischemic J wave is a new early warning indicators of sudden cardiac death.
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