Exercise capacity in patients 3 days after acute, uncomplicated myocardial infarction.
In a randomized, controlled trial of early hospital discharge after acute myocardial infarction (MI), a heart rate, symptom-limited exercise thallium test was performed after the onset of MI. Patients' exercise capacity was evaluated by the exercise treadmill with accompanying thallium scintigraphy. Of 507 consecutive patients screened, the condition of 179 was classified as uncomplicated, which is defined as the absence of angina, heart failure, or serious arrhythmias at 72 hours from admission. Of the patients with uncomplicated conditions, 126 had an exercise test on day 3 and 53 did not exercise on day 3. Of the 126 patients who exercised on day 3, 36 had a positive test and 90 had a negative test for ischemia. The 36 patients with a positive test result exercised a mean time of 6.71 +/- 2.8 minutes, achieved a mean peak heart rate of 120.9 +/- 21.4 beats/min, reached a peak systolic blood pressure of 144.7 +/- 33.3 mm Hg, and achieved a double product (rate-pressure product) of 183.4 +/- 67.6. The 90 patients with a negative test result for ischemia exercised 9.45 +/- 12.7 minutes, achieved a peak heart rate of 130.2 +/- 14.4 beats/min, reached a mean systolic blood pressure of 155.5 +/- 29.4 mm Hg, and achieved a rate-pressure product of 210.5 +/- 44.0. Of the 90 patients with uncomplicated conditions who had a negative exercise test for ischemia, 85 patients received reperfusion therapy, which included thrombolysis or coronary angioplasty or both.(ABSTRACT TRUNCATED AT 250 WORDS)
Burek
K A
KA
Department of Internal Medicine, University of Michigan Medical School, Ann Arbor.
Kirscht
J
J
Topol
E J
EJ
D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003422:Critical Care / Q000379:methods; D004434:Early Ambulation; D015444:Exercise; D005080:Exercise Test / Q000379:methods / Q000451:nursing; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000451:nursing / Q000503:physiopathology*; D010351:Patient Discharge; D010353:Patient Education as Topic / Q000379:methods; D011877:Radionuclide Imaging; D011897:Random Allocation; D013794:Thallium Radioisotopes
D013794:Thallium Radioisotopes