Key result
High-risk features on early post-MI exercise testing identified a group of patients with a 4.5-year survival probability of 25.0% compared to 76.7% in the remaining patients (P<10^-5).
Why the study?
Does early post-myocardial infarction exercise testing predict survival in patients 70 years or older?
Cohort (n=62)
Does early post-myocardial infarction exercise testing predict survival in patients 70 years or older?
Absolute Event Rate: 25% vs 76.7%
p-value: p=<10^-5
Early post-MI exercise testing in patients ≥70 years can identify a high-risk subgroup with significantly reduced 4.5-year survival based on pressure-rate product and ventricular arrhythmias.
May identify high-risk older post-MI patients; leaves open whether testing improves outcomes or should guide care.
A subjective maximal exercise test was performed in 62 patients, 70 years of age or more, in the third week after an acute myocardial infarction. Forty-two percent of the surviving AMI population in this age group could be tested. The estimated aerobic work capacity of the patients was on the average about 3 mets. Their maximal heart rate was about 70-80% below the normal age predicted maximum. A low increase of the pressure-rate product from rest to maximal exercise and occurrence of major exercise associated ventricular arrhythmias identified a high-risk group of 32 patients with probability of 4.5 year survival of 0.250 vs 0.767 in the remaining patients (P less than 10(-5)).
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Kari Saunamäki (1984) conducted a cohort in Acute myocardial infarction (n=62). High-risk features on early post-MI exercise testing (low increase of pressure-rate product and major ventricular arrhythmias) vs. Absence of high-risk features was evaluated on 4.5 year survival (p=<10^-5). High-risk features on early post-MI exercise testing identified a group of patients with a 4.5-year survival probability of 25.0% compared to 76.7% in the remaining patients (P<10^-5).
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