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May 7, 1994BMJ

Early exercise testing after treatment with thrombolytic drugs for acute myocardial infarction: importance of reciprocal ST segment depression

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Why the study?

Does reciprocal ST depression induced by early exercise testing indicate multivessel disease or reversible ischemia in patients with acute myocardial infarction treated with thrombolysis?

Population

202 patients (170 men) aged 33-69 with acute myocardial infarction treated with thrombolysis.

Comparison

Early exercise testing post-myocardial… vs Isolated ST segment depression

Design

Cohort

Authors

RSRobert StevensonUniversity Hospitals Birmingham NHS Foundation TrustVUV UmachandranBroomfield HospitalKRKulasegaram RanjadayalanBarts Health NHS Trust

Discussion

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Implication

Reciprocal ST depression should not prompt multivessel evaluation post-thrombolysis; leaves open its prognostic value in contemporary reperfusion.

Structured PICO

Does reciprocal ST depression induced by early exercise testing indicate multivessel disease or reversible ischemia in patients with acute myocardial infarction treated with thrombolysis?

P
Population
202 patients (170 men) aged 33-69 with acute myocardial infarction treated with thrombolysis.
I
Intervention
Early exercise testing post-myocardial infarction evaluating reciprocal ST segment depression
C
Comparator
Isolated ST segment depression
O
Outcome
Relation between reciprocal ST depression and characteristics of the infarct, left ventricular ejection fraction, extent of coronary artery disease on arteriography, and presence of angina induced by exercisesurrogate

Reciprocal ST depression during early exercise testing post-myocardial infarction indicates extensive infarction and persistent infarct-related artery occlusion rather than reversible ischemia from multivessel disease.

Cite This Study

Stevenson et al. (1994) studied this question.

synapsesocial.com/papers/6a1a8edd7ff99bba0645dbf4https://doi.org/10.1136/bmj.308.6938.1189
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Limited Exercise Testing Soon After Myocardial Infarction1981 · 99 citations
  2. 2ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm.1978 · 120 citations
  3. 3Early Post-myocardial Infarction Treadmill Stress Testing1981 · 103 citations
  4. 4Use of radionuclide angiography and an electrocardiographic stress test to diagnose multivessel disease after a first episode of uncomplicated myocardial infarction.1986 · 9 citations
  5. 5Noninvasive prediction of multivessel disease after myocardial infarction.1980 · 60 citations