The influence of thrombolytic therapy on the predictive value of exercise testing 3 weeks after acute myocardial infarction.

Abstract:

OBJECTIVES:To evaluate the prognostic value of exercise testing performed soon after acute myocardial infarction (AMI) in patients treated with thrombolytic therapy. DESIGN:A 1-year prospective follow-up of 185 subjects treated with thrombolytic therapy who survived AMI, and who performed exercise testing 3 weeks after AMI. These patients were compared with 272 patients not receiving thrombolytic therapy during the same period. SUBJECTS:Patients recovering from AMI, without medical contraindications to exercise testing performed 3 weeks after AMI. MAIN OUTCOME MEASURES:ST-segment deviations during exercise testing 3 weeks post-AMI were related to clinical outcome 1-year post-AMI and to the administration of thrombolytic therapy during the acute phase of infarction. RESULTS:In patients treated with thrombolytic therapy, the only exercise-test-related parameter predicting subsequent cardiac events was ST-segment elevation. In contrast, patients not receiving thrombolytic therapy and demonstrating ST-segment depression of > or = 1 mm during exercise had more clinical cardiac events than those without this finding (12.3 vs. 3.9%; P < 0.05). CONCLUSION:This study casts doubt on the ability of exercise testing to select a high-risk population requiring early intervention to prevent recurrent coronary events after thrombolysis for AMI.

journal_name

J Intern Med

authors

Abboud L,Hir J,Eisen I,Markiewicz W

doi

10.1111/j.1365-2796.1994.tb00841.x

subject

Has Abstract

pub_date

1994-11-01 00:00:00

pages

537-42

issue

5

eissn

0954-6820

issn

1365-2796

journal_volume

236

pub_type

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