What question did this study set out to answer?

To evaluate the relationship between transient myocardial ischaemia detected by ambulatory ST-segment monitoring and exercise treadmill testing in patients recovering from acute myocardial infarction.

March 1, 1991European Heart Journal

Transient ischaemia after acute myocardial infarction: relationship to exercise ischaemia

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Why the study?

Does ambulatory ST segment monitoring detect transient ischaemia as effectively as exercise treadmill testing in patients 4-8 weeks after acute myocardial infarction?

Population

170 patients (mean age 58 years) evaluated at 4-8 weeks after admission for acute myocardial infarction.

Comparison

Ambulatory ST segment monitoring (24 hours) vs Exercise treadmill testing

Design

Cross-sectional

Authors

PCPhilip J. CurrieUniversity of Alberta SSS SaltissiDeakin University

Discussion

Member takes

Implication

Ambulatory monitoring may underdetect post-MI ischaemia versus exercise testing; leaves open its added value for risk stratification in observational data.

Key Points

To evaluate the relationship between transient myocardial ischaemia detected by ambulatory ST-segment monitoring and exercise treadmill testing in patients recovering from acute myocardial infarction.
Evaluated 170 patients (mean age 58 years) at 4 to 8 weeks following hospital admission for acute myocardial infarction.
Compared 24-hour ambulatory ST-segment monitoring against symptom-limited exercise treadmill testing.
Ambulatory monitoring identified transient ischaemia in 31% of patients (53/170; 249/265 [94%] episodes silent), which was significantly less frequent than exercise-induced ischaemia at 53% (90/170; P < 0.0001).
Patients with ambulatory ischaemia had shorter exercise times (248.7 ± 17.2 vs 318.7 ± 14.1 s, P < 0.006), earlier ST deviation (172.4 ± 14.3 vs 244.8 ± 16.2 s, P < 0.0004), and more ECG leads involved (3.8 ± 0.3 vs 2.5 ± 0.2, P < 0.005).
Positive ambulatory monitoring was present in 15% (12/80) of patients with negative exercise tests, but captured 82% (9/11) of patients with easily provoked exercise ischaemia.

Structured PICO

Does ambulatory ST segment monitoring detect transient ischaemia as effectively as exercise treadmill testing in patients 4-8 weeks after acute myocardial infarction?

Population

170 patients (mean age 58 years) evaluated at 4-8 weeks after admission for acute myocardial infarction.

Intervention

Ambulatory ST segment monitoring (24 hours)

Comparator

Exercise treadmill testing

Outcome

Detection of transient myocardial ischaemiasurrogate

Routine 24-hour ambulatory monitoring has a limited role for diagnosing ongoing ischaemia after myocardial infarction compared to exercise testing, though it may help identify patients with easily provoked ischaemia.

Cite This Study

Currie et al. (1991) studied this question.

synapsesocial.com/papers/6a8bf241de5ec4e001e3de40 https://doi.org/10.1093/oxfordjournals.eurheartj.a059907

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Implication

Ambulatory monitoring may underdetect post-MI ischaemia versus exercise testing; leaves open its added value for risk stratification in observational data.

Transient ischaemia after acute myocardial infarction: relationship to exercise ischaemia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Transient ischaemia after acute myocardial infarction: relationship to exercise ischaemia

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider