August 1, 1984Open Access
Submaximal exercise testing early after myocardial infarction. Prognostic importance of exercise induced ST segment elevation.
Key Result
Exercise-induced ST segment elevation during submaximal exercise testing early after myocardial infarction best predicted future complications and was the only predictor of cardiac death.
Study Design
Type
Cohort (n=74)
Structured PICO
Does exercise-induced ST segment elevation during submaximal exercise testing early after myocardial infarction predict subsequent cardiac events?
P
Population
74 patients (mean age 54.3 years) evaluated 7-23 days after acute myocardial infarction with submaximal exercise testing and followed for a mean of 11.3 months.
E
Exposure
Submaximal exercise testing with assessment of exercise-induced ST segment elevation, ST shift, ST depression, exercise capacity, and blood pressure response.
C
Comparator
Patients with no exercise-induced abnormality on submaximal exercise testing.
O
Outcome
Subsequent cardiac events (composite of cardiac death, left ventricular failure, recurrent myocardial infarction, angina) at mean 11.3 months follow-up.composite
Exercise-induced ST segment elevation during early submaximal exercise testing after acute myocardial infarction is a strong predictor of future cardiac complications, including cardiac death.
Abstract
Seventy four patients (66 men, eight women; mean age 54.3 years) underwent submaximal exercise testing 7-23 days (mean 10.7) after acute myocardial infarction. Follow up was a mean period of 11.3 months. When compared with patients with no exercise induced abnormality, ST segment elevation, ST shift (depression or elevation or both), ST depression, inability to complete five metabolic equivalents, and inadequate blood pressure response to exercise were predictive of subsequent cardiac events (cardiac death, left ventricular failure, recurrent myocardial infarction, angina). When the presence or absence of specific variables was assessed, only ST elevation and ST shift predicted subsequent cardiac events. The presence of exercise induced ST elevation was the only exercise test variable which predicted cardiac death. ST segment elevation was, therefore, the exercise induced abnormality which best predicted the risk of future complications.