[Early stress tests following an uncomplicated myocardial infarct: a comparison between symptom-limited and submaximal tests].
To compare the diagnostic and prognostic usefulness of symptom-limited versus load-limited submaximal stress testing, 76 patients, during the first week post acute non-complicated myocardial infarction, were submitted to a symptom-limited Naughton-modified protocol stress test. At 2 METs, 3 METs and maximal effort levels, the tests were classified as positive or negative following the currently used criteria. After a mean follow-up of 15 months, the symptom-limited protocol showed the best sensitivity (95%), specificity (78%), positive (64%) and negative (98%) predictive value, and also the highest risk ratio (27.4) for prediction of subsequent coronary events (2p less than 0.01 vs 2 METs, 3 METs and 2D-Echocardiogram results). Forward stepped multiple correlation analysis indicated independent prognostic value for the results of the symptom-limited stress test (R2: .52 p less than 0.01) and for the location of the myocardial infarction (R2: .05 p less than 0.05) only. In addition, the discriminant prognostic power of the symptom-limited protocol was significant after the fourth month of follow-up (2p less than 0.05 vs submaximal tests and 2D-Echo). Therefore, we recommend the performance of a symptom-limited stress test during the first week post acute non-complicated myocardial infarction, provided that all coronary active medication has been withheld 24 hours before the test.
López
J
J
Centro de Investigaciones Cardiovasculares Dr. Abdel Fuenmayor, Unidad de Cardiología, Hospital Universitario de los Andes, Universidad de los Andes, Mérida, Venezuela.
Carrasco
H A
HA
Portillo
S
S
Maldonado
Z
Z
Monzón de Briceño
Y
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography; D004562:Electrocardiography; D005080:Exercise Test / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D011379:Prognosis; D012008:Recurrence; D013997:Time Factors
Las pruebas de esfuerzo tempranas postinfarto miocárdico no complicado: comparación entre limitadas por síntomas y submaximas.