Two management policies for patients after myocardial infarction: Does exercise testing and a more intensive approach make any difference?

Q: What is the clinical evidence from this study?

Study design: Letter. Population: Bilateral oophorectomy and hysterectomy. Intervention: Hormone replacement therapy.

John E. Sanderson; E. Whiteley; Katharina Neubauer; Barry Ma

doi:10.1136/bmj.299.6713.1435

December 9, 1989BMJOpen Access

Two management policies for patients after myocardial infarction: Does exercise testing and a more intensive approach make any difference?

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Why the study?

Does an intensive management policy including exercise testing improve symptom status and mortality in patients after myocardial infarction compared to standard management?

Structured PICO

Does an intensive management policy including exercise testing improve symptom status and mortality in patients after myocardial infarction compared to standard management?

P

Population

234 patients under age 70 with proved myocardial infarction admitted as emergencies into the coronary care unit (Group A n=121, Group B n=113).

E

Exposure

Intensive management policy including limited exercise testing before discharge (stage II modified Bruce protocol), full symptom-limited exercise test at 1 month, and higher rates of beta-blocker use, angiography, and coronary artery bypass grafting.

C

Comparator

Standard management policy with a 1-month clinical follow-up and discharge to general practitioner if well.

O

Outcome

Symptom status (angina, heart failure, claudication) and mortality at follow-up.

Limitations

Not strictly randomised or controlled
Difficult to ascertain if the cost of procedures justifies the results

Implication

An intensive post-myocardial infarction management strategy incorporating routine exercise testing, beta-blockers, and revascularization is associated with improved long-term symptom control.

Abstract

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Discussion

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Cite This Study

Sanderson et al. (1989) conducted a letter in Bilateral oophorectomy and hysterectomy. Hormone replacement therapy was evaluated.

synapsesocial.com/papers/6a95841ee944c9d957332daa https://doi.org/10.1136/bmj.299.6713.1435

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Two management policies for patients after myocardial infarction: Does exercise testing and a more intensive approach make any difference?

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

Two management policies for patients after myocardial infarction: Does exercise testing and a more intensive approach make any difference?

Structured PICO

Limitations

Implication

Abstract

Discussion

Cite This Study

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