Document Detail


Actual clinical practice of exercise testing in consecutive patients after non-ST-elevation myocardial infarction: results of the acute coronary syndromes registry.
MedLine Citation:
PMID:  16926678     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Exercise testing has been advocated for risk stratification and determination of therapeutic strategies after acute myocardial infarction. Frequency and therapeutic impact of exercise testing after non-ST-elevation myocardial infarction (NSTEMI) in actual clinical practice, however, is not known. METHODS AND RESULTS: From the German acute coronary syndrome (ACOS) registry patients with acute NSTEMI (n = 5281) were evaluated: 20.8% of patients (1097/5281) had predischarge exercise testing, and from these tests 33.5% (367/1097) were positive. The strongest predictors for renunciation of predischarge exercise testing were ejection fraction under 40%, age over 70 years and stroke history. In-hospital coronary angiographies or percutaneous coronary interventions were not associated with a lower rate of exercise testing. During 1-year follow-up all-cause mortality was 13.6% in patients without and 5.1% in patients with exercise test respectively (P < 0.0001). In patients with positive exercise test 1-year mortality was 6.5%, in patients with negative exercise test 4.4% (P = 0.13). During follow-up no significant difference was found in the rate of coronary revascularizations between patients either with positive or negative exercise tests. Furthermore, no significant difference was found in the rate of death and revascularizations comparing different groups of exercise capacity. CONCLUSIONS: After NSTEMI in Germany the majority of patients do not get predischarge exercise testing, although this group appears to be of special risk for fatality during follow-up. Furthermore, in actual clinical practice, neither exercise induced signs of ischemia nor exercise capacity have a significant impact on the rate of revascularization procedures during follow-up.
Authors:
Harm Wienbergen; Anselm Kai Gitt; Rudolf Schiele; Claus Juenger; Tobias Heer; Martin Gottwik; Joachim Manthey; Albrecht Hempel; Kurt Bestehorn; Jochen Senges; Bernhard Rauch;
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  13     ISSN:  1741-8267     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-08-23     Completed Date:  2006-09-08     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  457-63     Citation Subset:  IM    
Affiliation:
Heart Center Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany. HarmWnbrgn@aol.com
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Transluminal, Percutaneous Coronary / statistics & numerical data
Coronary Artery Bypass / statistics & numerical data
Exercise Test*
Humans
Logistic Models
Myocardial Infarction / mortality,  physiopathology*,  therapy
Registries
Risk
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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