Document Detail

Ambulatory ST-recording has no additional value to exercise test for identification of severe coronary lesions after an episode of unstable coronary artery disease in men.
MedLine Citation:
PMID:  8133126     Owner:  NLM     Status:  MEDLINE    
One month after an episode of unstable coronary artery disease, 95 male patients performed coronary angiography, 48 hours ambulatory ST-recording and also an exercise test. ST-depression occurred in 29.5% during the ST-recording and in 44.2% during the exercise test (p < 0.05). In patients with ST-depression at ambulatory monitoring, 79% demonstrated the same finding at the exercise test. A high risk response at the exercise test--defined as either ST-depression in > or = 3 leads, ST-depression in 1-2 leads with a maximal work load below the 60th percentile or a maximal work load below the 30th percentile regardless of the ECG reaction--occurred in 56.8%. Severe coronary lesions--defined as three vessel disease, left main stenosis or proximal left anterior descending artery stenosis as part of two vessel disease--was observed in 46.3%. Patients with a high risk exercise test response and patients with ST-depression during ST-recording had severe coronary lesions in 67% and 64% respectively. However, a high risk exercise test response occurred in 82%, while ST-depression at ambulatory monitoring was observed only in 41% of the patients with severe coronary lesions (p < 0.001). Thus, ambulatory ST-recording one month after an episode of unstable coronary artery disease in men adds no further information to a symptom limited exercise test in order to identify patients with severe coronary lesions.
J E Karlsson; A Björkholm; P Blomstrand; J Ohlsson; L Wallentin
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cardiac imaging     Volume:  9     ISSN:  0167-9899     ISO Abbreviation:  Int J Card Imaging     Publication Date:  1993 Dec 
Date Detail:
Created Date:  1994-04-21     Completed Date:  1994-04-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8600426     Medline TA:  Int J Card Imaging     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  281-9     Citation Subset:  IM    
Department of Cardiology, University Hospital, Linköping, Sweden.
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MeSH Terms
Angina, Unstable / complications*
Coronary Disease / diagnosis*
Double-Blind Method
Electrocardiography, Ambulatory*
Exercise Test*
Middle Aged
Prospective Studies

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