Does thrombolysis affect the prognostic value of the post-infarct exercise test?

Abstract:

:There has been some debate on usefulness of the exercise test in risk stratification after myocardial infarction in the thrombolytic era. This was assessed in 295 patients of whom 184 were treated with thrombolysis. Each had an exercise test using a modified Naughton protocol within 14 days of acute myocardial infarction. The tests were graded as high risk positive (112), low risk positive (83), or negative (100). These gradings predicted use of multiple drug therapy (p = 0.05), severity of coronary artery disease (p < 0.01), and coronary artery bypass grafting (p < 0.01). There was no influence on heart failure, recurrent myocardial infarction or death. This was independent of the use of thrombolytic therapy. The whole group had a good prognosis with a mortality of 2.4% after 56 weeks' follow-up. The exercise test is still a useful screening test after myocardial infarction. In this study, there was a high negative predictive accuracy of 91% for any event. Its use is not altered by thrombolysis. The finding of a lack of influence of the exercise test on major events may be a reflection of the current good prognosis after myocardial infarction and the prompt use of revascularisation.

journal_name

Int J Cardiol

authors

Wosornu D,Goh KY,Gooptu C,Beattie JM,Murray RG

doi

10.1016/0167-5273(94)90128-7

subject

Has Abstract

pub_date

1994-11-01 00:00:00

pages

13-20

issue

1

eissn

0167-5273

issn

1874-1754

pii

0167-5273(94)90128-7

journal_volume

47

pub_type

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