| Exercise-provoked ST-segment depression and prognosis in patients recovering from acute myocardial infarction. Significance and pitfalls. | |
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MedLine Citation:
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PMID: 8429283 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The importance of maximal versus submaximal exercise testing and the significance of heart failure on the prognostic value of exercise-provoked ST-segment depression > or = 0.1 mV was studied in 143 patients recovering from acute myocardial infarction. Patients were exercise tested prior to discharge and follow up lasted for up to 18 months (mean 17 months). End-point was first major event (i.e. first non-fatal reinfarction or death). A symptom-limited exercise test was superior to a heart-rate-limited test in detecting ST-segment depressions (27% vs. 20%: P < 0.5), and patients with ST-segment depression at lower heart rates did not have an increased risk of subsequent events compared with patients with ST-segment depression at higher heart rates (14% vs. 27%; NS). Heart failure surpassed ST-segment depression as a risk predictor (34% vs. 18%). Based on a meta-analysis including 13 studies (1987 patients) exercise-provoked ST-segment depression possessed an increased risk of subsequent major events (P < 0.0001; risk ratio = 1.90; 95% confidence limits 1.43,2.51). Thus, ST-segment depression provoked by a symptom-limited test selects patients with an increased risk of subsequent major events. In patients with a history of heart failure exercise-provoked ST-segment depression is of limited value. |
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Authors:
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C M Jespersen; L Hagerup; N Holländer; J Launbjerg; N C Linde; E Steinmetz |
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Publication Detail:
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Type: Journal Article; Meta-Analysis |
Journal Detail:
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Title: Journal of internal medicine Volume: 233 ISSN: 0954-6820 ISO Abbreviation: J. Intern. Med. Publication Date: 1993 Jan |
Date Detail:
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Created Date: 1993-03-11 Completed Date: 1993-03-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8904841 Medline TA: J Intern Med Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 27-32 Citation Subset: IM |
Affiliation:
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Municipal Hospital, Medical Department 2, Copenhagen, Denmark. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Electrocardiography* Exercise Test* Follow-Up Studies Heart Failure / complications Humans Myocardial Infarction / complications, diagnosis, physiopathology* Odds Ratio Prognosis Recurrence |
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