Relative prognostic value of clinical, exercise, and angiographic data after a first myocardial infarction.
BACKGROUND
Studies examining the relative value of clinical, exercise test, and angiographic data in the prediction of further clinical events after a first acute myocardial infarction (AMI) have produced conflicting results.


METHODS
We examined the relative value of clinical, exercise test, and angiographic data as predictors of death, recurrent infarction, and the subsequent development of angina or dyspnea in 303 consecutive patients who underwent exercise testing and coronary angiography within 2 months of an uncomplicated first acute myocardial infarction (AMI), and who were followed for 48 (+/- 22) months.


RESULTS
A combination of two clinical and two exercise variables correctly identified 79% of subsequent deaths. No variables had a predictive value for re-infarction. A combination of two exercise variables correctly identified 75% of patients who developed angina during follow up. A combination of two clinical variables and one exercise variable correctly identified 76% of patients who developed dyspnea during follow up.


CONCLUSIONS
Exercise testing provided useful prognostic information independent of clinical data. Combining clinical and exercise data identified a group of patients at low risk of future events. In this low-risk group of patients, the addition of angiographic data did not provide additional prognostic information.
Leroy
F
F
Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Lille, France.
Lablanche
J M
JM
McFadden
E P
EP
Bauters
C
C
Bertrand
M E
ME
D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D016002:Discriminant Analysis; D004417:Dyspnea / Q000175:diagnosis; D005080:Exercise Test; D005260:Female; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality* / Q000503:physiopathology* / Q000601:surgery; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate