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The composite endpoint included not only arrhythmic events. The successful PCI (TIMI 3) within 12 hours from symptom onset was the inclusion criterion. Almost all patients were treated with beta-blocking agents, ACE inhibitors or angiotensin receptor blockers and statins. The first anterior infarction patients were enrolled for the homogeneity, as we consider them as a higk selleck compound risk group. Ikeda et al. [ 6] has already shown that MTWA is a highly specific predictor of ventricular arrhythmias in patients after recent MI. In a study of 850 post-MI patients MTWA predicted sudden cardiac death or resuscitated ventricullar fibrillation with a relative hazard of 11.4 during 25 month follow-up. Moreover, the negative predictive value was 99.5%. Similarly, there was also a high negative predictive value of MTWA in post MI patients with depressed left ventricular function (LVEF��40%) [5], in whom prophylactic ICD placement improved survival. It is possible that patients with negative MTWA may not necessarily need prophylactic ICD. In another study Ikeda et al. [ 14] showed that a positive microvolt TWA test, NSVT on Holter monitoring, and ventricular LP were all significant predictors of sudden cardiac death or life-threatening arrhythmic events in patients selleck inhibitor with preserved cardiac function after myocardial infarction, with a positive microvolt TWA test the most significant predictor, with a hazard ratio of 19.7 (95% CI 5.5 to 70.4; p CAPNS1 of patients for sudden cardiac death in those patients with preserved cardiac function. Risk stratification may differ between patients with reduced LVEF and those with preserved LVEF. Tapanainen et al. [ 15], in single-centre prospective multiple risk factors analysis, did not show that MTWA during predischarge exercise tests was associated with increased risk of mortality among survivors of acute MI. However, functional impairment and inability to reach target rate of 105 bpm were the mo st powerful predictors of death among several known risk variables in this consecutive series of patients. On the other hand, more recent reports have questioned the MTWA ability to predict ventricular tachyarrhythmic events, confirming the test value as mortality predictor [ 9]. In our study, the presence of non-negative MTWA was more common in larger infarctions assessed with biochemical markers but during acute phase of infarction. This has changed at day 30, due to recovery of LV function in some patients. The echocardiographic indexes were significantly better in MTWA negative patients. Such relationship has not been described before. During 4-year follow-up the event rate was relatively low (23%) and most of the events happened during the first two years (20 out of 26). The combined end point included not only all-cause mortality (8.