title: Clinical significance of the ST-segment response and other early exercise test variables in uncomplicated vs complicated myocardial infarction.
abstract: An exercise test was performed in 455 patients in the third week after acute myocardial infarction (AMI). One hundred and seventeen (26%) of them were considered as having a complicated AMI. During a follow-up of 4.5 years their mortality was 49% vs 23% in the remaining patients with uncomplicated AMI. The survival of the patients was assessed in each clinical group in relation to various exercise variables. Exercise-induced ST-segment depression, irrespective of its degree, did not discriminate significantly between dead and living patients in any of the clinical groups. A high value of the rise of the pressure-rate product (PRP) from rest to maximal exercise (dPRP) and absence of significant exercise-induced ventricular arrhythmias identified in both clinical groups patients with a very low risk of dying. A low dPRP and/or occurrence of significant ventricular arrhythmias identified a relatively high risk in uncomplicated AMI patients and a very high risk of dying in complicated AMI subjects. The difference in the probability of survival between low-risk and high-risk patients was highly significant in each clinical group (P less than 0.0001 in uncomplicated, and less than 0.005 in complicated AMI, respectively).
mesh_terms: D000328:Adult; D000368:Aged; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000503:physiopathology*; D011379:Prognosis