Early assessment of long-term risk with continuous ST-segment monitoring among patients with unstable coronary syndromes. Results from 1-year follow-up in the TRIM study

A total of 323 patients who took part in the TRIM trial underwent an initial 24 h continuous electrocardiogram ST-segment monitoring. A ST vector magnitude (ST-VM) maximum greater than or equal to 24 muV predicted death or myocardial infarction within 1 year with a 78% specificity and a 52% sensitivity, an area under the ST-VM trend curve greater than or equal to 162 mu with a 86% specificity and a 42% sensitivity and presence of ST-VM episodes with a 70% specificity and a 68% sensitivity. Patients who had neither ST-VM episodes nor a ST-maximum greater than or equal to 144 muV had only a 4.5% incidence of death or myocardial infarction within one year as compared to 18% among those patients who met any of these criteria. ST-segment monitoring with continuous vectorcardiography is feasible for risk stratification at least up to 1 year after an episode of unstable coronary artery disease and several vectorcardiographic parameters may be used.