What is the clinical evidence from this study?

Study design: Observational. Population: acute myocardial infarction (n=289). Intervention: Exercise treadmill testing. Primary outcome: anatomic restenosis (p=0.02).

What question did this study set out to answer?

To evaluate whether exercise treadmill testing can accurately predict anatomic restenosis six months following emergency angioplasty for acute myocardial infarction.

December 1, 1989CirculationOpen Access

Exercise treadmill testing is a poor predictor of anatomic restenosis after angioplasty for acute myocardial infarction.

Q: What does this research mean for the field?

Exercise treadmill testing and angina symptoms have poor sensitivity and limited value for predicting anatomic restenosis 6 months after emergency angioplasty for acute myocardial infarction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

Exercise treadmill testing poorly predicts 6-month anatomic restenosis after AMI angioplasty with ~24% sensitivity.

P=0.02
n=289

Why the study?

Does exercise treadmill testing predict anatomic restenosis in patients 6 months after emergency angioplasty for acute myocardial infarction?

Population

140 patients evaluated 6 months after successful emergency angioplasty for acute myocardial infarction.

Comparison

Exercise treadmill testing vs Cardiac catheterization

Design

Cohort

Follow-up

6 months

Authors

MHMichael B. HonanAdvocate Lutheran General Hospital JBJames R. BengtsonSahlgrenska University Hospital DPD B PryorLeeds General Infirmary

Discussion

Member takes

Implication

Exercise testing should not guide restenosis assessment after emergency angioplasty; observational data leaves open need for better noninvasive predictors.

Key Points

To evaluate whether exercise treadmill testing can accurately predict anatomic restenosis six months following emergency angioplasty for acute myocardial infarction.
Assessed 289 post-infarct patients treated with emergency angioplasty, ultimately analyzing 140 eligible individuals who completed both an exercise treadmill test and cardiac catheterization at 6-month follow-up.
Used multivariable logistic regression to analyze six clinical and treadmill variables for independent associations with angiographic restenosis and multivessel coronary disease.
Exercise ST deviation of 0.10 mV or greater was the only independent predictor of restenosis (chi-square = 5, p = 0.02), yielding a sensitivity of 24% (13 of 55 patients) and a specificity of 88% (75 of 85 patients).
Angina symptoms marginally correlated with restenosis in univariable analysis (p = 0.04) but provided no added diagnostic value once ST deviation was known, and diagnostic sensitivity remained unaltered by infarct size, collateral flow, or reperfusion timing.
Exercise ST deviation (p = 0.003) and exercise duration (p = 0.04) significantly correlated with the total number of diseased vessels identified during 6-month catheterization.

Study Design

Type

Observational (n=289)

Structured PICO

Does exercise treadmill testing predict anatomic restenosis in patients 6 months after emergency angioplasty for acute myocardial infarction?

Population

289 patients evaluated 6 months after successful emergency angioplasty for acute myocardial infarction, with 140 undergoing both treadmill testing and cardiac catheterization.

Exposure

Exercise treadmill testing

Comparator

Cardiac catheterization (reference standard for anatomic restenosis)

Outcome

Anatomic restenosis at 6 monthssurrogate

Main Result

p-value: p=0.02

Exercise treadmill testing has limited sensitivity and is a poor predictor of anatomic restenosis 6 months after emergency angioplasty for acute myocardial infarction.

Cite This Study

Honan et al. (1989) conducted an observational in acute myocardial infarction (n=289). Exercise treadmill testing was evaluated on anatomic restenosis (p=0.02). Exercise treadmill testing had limited value for predicting anatomic restenosis 6 months after emergency angioplasty for acute myocardial infarction, with ST deviation showing only 24% sensitivity.

synapsesocial.com/papers/6aa53da522b0548423395b21 https://doi.org/10.1161/01.cir.80.6.1585

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Implication

Exercise testing should not guide restenosis assessment after emergency angioplasty; observational data leaves open need for better noninvasive predictors.

Exercise treadmill testing is a poor predictor of anatomic restenosis after angioplasty for acute myocardial infarction.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Exercise treadmill testing is a poor predictor of anatomic restenosis after angioplasty for acute myocardial infarction.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

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