Why the study?
Does the detection of transient myocardial ischemia on serial Holter monitoring predict long-term adverse cardiac events in male survivors of a first acute myocardial infarction?
Does the detection of transient myocardial ischemia on serial Holter monitoring predict long-term adverse cardiac events in male survivors of a first acute myocardial infarction?
Routine serial Holter monitoring for transient myocardial ischemia does not predict long-term adverse cardiac events and is not recommended in male survivors of an uncomplicated first acute myocardial infarction.
Answers are grounded in this paper and cite their sources.
Does not support routine Holter monitoring after uncomplicated MI; leaves open whether ischemia detection refines long-term risk stratification.
Based on serial Holter monitoring performed 7 times within 3 years after a first acute myocardial infarction, we assessed the prevalence, variability and long-term clinical importance of transient myocardial ischemia (TMI) defined as episodes of ambulatory ST-segment depression. In all, 121 consecutive male patients <70 years old were studied. The prevalence of TMI on different Holter recordings varied around 20% ranging between 18 and 27%. Fifty-five of the patients (46%) had TMI on at least 1 of the 7 Holter recordings. Considerable variability was found within and between patients for the presence of TMI. No high-risk group for cardiac death, nonfatal reinfarction or coronary revascularization during up to 10 years of follow-up could be identified by the detection of TMI. From these results we conclude that a routine search for TMI on serial Holter monitoring cannot be recommended in male survivors of an uncomplicated first acute myocardial infarction.
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Mickley et al. (1998) studied this question.
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