Early exercise stress testing is safe after primary percutaneous coronary intervention.
BACKGROUND
The optimal timing of exercise stress testing post primary percutaneous coronary intervention is uncertain with anecdotal evidence suggesting an increased risk of acute myocardial infarction and/or death if performed too early. This has translated into a delayed return to normal life activities following an acute myocardial infarction resulting in an increase in socio-economic burden.


OBJECTIVE
We hypothesize that early (within 7 days of primary percutaneous coronary intervention) exercise stress testing is safe.


METHODS
A prospective study of consecutive patients enrolled into the Cardiac Rehabilitation Program at a tertiary referral centre that underwent primary percutaneous coronary intervention, and who were able to perform a treadmill stress test were recruited. Timing of exercise stress testing was within 7 days post primary percutaneous coronary intervention and outcomes of death, acute myocardial infarction and other major adverse cardiac event were assessed 24 hours post exercise stress testing.


RESULTS
Recruited patients (n=230) aged between 29 and 78 (mean age 56 ± 10 years) with 191 being males (83%) and 39 being females (17%). While 28 patients had a positive stress test (12.2%), there were no deaths, acute myocardial infarction or any other major adverse cardiac event within 24 hours of performing the exercise stress testing. Mean METS achieved were 8.1 ± 2.3.


CONCLUSIONS
Early exercise stress testing after primary percutaneous coronary intervention appears safe.
Department of Cardiology, Westmead Hospital, Westmead, Australia ; The University of Sydney, Australia.
Ajita
A
Kanthan
Timothy C
TC
Tan
Robert P
RP
Zecchin
Alan Robert
AR
Denniss
Acute myocardial infarction; STEMI; exercise stress test; primary percutaneous coronary intervention