Document Detail


Exercise-induced symptomatic ischaemia predicts a poor long-term prognosis after acute myocardial infarction.
MedLine Citation:
PMID:  11851865     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY OBJECTIVES: To evaluate the long-term prognostic significance of symptomatic ischaemia during exercise testing performed 3 weeks after acute myocardial infarction (AMI). DESIGN: A prospective study with long-term follow-up. SETTING: A Cardiac Rehabilitation Clinic in a University Hospital. SUBJECTS: A total of 446 patients were allowed to perform exercise testing 3 weeks after AMI and followed for 72 +/- 20 months. MEASUREMENTS AND RESULTS: Patients were divided into three groups according to whether they had no ECG evidence of ischaemia during exercise testing (334 patients), silent ischaemia (90 patients) or symptomatic ischaemia (22 patients). Cardiac death was significantly more frequent in patients with symptomatic ischaemia when compared with silent ischaemia (31.8% vs. 7.8%, P < 0.01) or when compared with no ischaemia (31.8% vs. 10.2%, P < 0.01). The three groups had a low cardiac mortality during the first 48 months of follow-up. The prognosis of patients with symptomatic ischaemia worsens markedly thereafter. The results of exercise testing did not predict recurrence of myocardial infarction. Coronary revascularization was performed in 34.4% of those without ischaemia, 47.8% of those with silent ischaemia and 45.5% of those with symptomatic ischaemia (P < 0.01). CONCLUSIONS: Patients with symptomatic ischaemia have a good prognosis during the first 4 years of follow-up. Their prognosis worsens thereafter as opposed to patients with or without silent ischaemia. This high-risk group of patients with symptomatic ischaemia deserves optimal management including revascularization when appropriate.
Authors:
L Abboud; J Hir; I Eisen; W Markiewicz
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of internal medicine     Volume:  251     ISSN:  0954-6820     ISO Abbreviation:  J. Intern. Med.     Publication Date:  2002 Jan 
Date Detail:
Created Date:  2002-02-19     Completed Date:  2002-03-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8904841     Medline TA:  J Intern Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  53-60     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Rambam Medical Center and Technion School of Medicine, Haifa, Israel.
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MeSH Terms
Descriptor/Qualifier:
Analysis of Variance
Angina Pectoris / complications
Chi-Square Distribution
Electrocardiography
Exercise Test
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction / mortality*,  physiopathology*
Myocardial Ischemia / etiology*
Prognosis
Proportional Hazards Models
Prospective Studies
Recurrence
Risk Factors
Survival Analysis

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


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