Early post-myocardial infarction treadmill stress testing. An accurate predictor of multivessel coronary disease and subsequent cardiac events.
Limited (heart rate to less than or equal to 120 beats/min) standardized treadmill stress testing was done before hospital discharge in 40 survivors of uncomplicated acute myocardial infarction. Each patient had subsequent coronary arteriography. Twenty-one had inferior, 10, anterior, and nine, nontransmural infarctions; in 30 patients this was their first infarction. A positive electrocardiographic response or angina, or both, occurred in 15 patients and correctly detected most patients with multivessel disease (sensitivity 67%, predictive value 87%) and patients at risk for coronary events: 35% of positive responders admitted for angina in the first month after discharge versus 4% of patients with a negative test (p less than 0.05). During a 7-month follow-up period, 73% of patients with a positive test result developed angina versus 16% of those with negative test results (p less than 0.001). Thus, predischarge post-myocardial infarction limited stress testing correctly identifies the high-risk subset of patients with multivessel coronary disease and thereby allows intelligent selection of patients for early coronary arteriography.
D000328:Adult; D000787:Angina Pectoris / Q000503:physiopathology; D000790:Angiocardiography; D003327:Coronary Disease / Q000503:physiopathology; D005080:Exercise Test; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000503:physiopathology*; D011379:Prognosis; D012306:Risk; D013318:Stroke Volume