Document Detail

Prognosis in patients with low left ventricular ejection fraction after myocardial infarction. Importance of exercise capacity.
MedLine Citation:
PMID:  2598426     Owner:  NLM     Status:  MEDLINE    
The measurement of left ventricular ejection fraction (LVEF) plays a key role in many strategies for managing patients after acute myocardial infarction. We tested the hypothesis that exercise capacity 1 month after myocardial infarction provides additional information in patients with a low LVEF and therefore assists in risk stratification. One hundred fifteen patients, with documented myocardial infarction and LVEF less than 35% by gated radionuclide scan 1 month after acute myocardial infarction, were followed up for 2 months to 7 years. Exercise capacity was estimated from a treadmill test 1 month after infarction. Using the Cox proportional hazards model, exercise capacity was a significant predictor of death or reinfarction. The relative risk of death, based on a comparison between the lowermost quintile (less than 4 METS) and uppermost quintile (greater than 7 METS), was 3.5 (95% confidence interval, 1.1-9.7); the relative risk in the fourth, third, and second quintile was 2.7, 2.1, and 1.6, respectively. In a multivariate analysis, the observed effect of a good exercise capacity was independent of LVEF. These data indicate that in patients with a low LVEF after myocardial infarction, useful prognostic information can be obtained from exercise testing.
L Pilote; J Silberberg; R Lisbona; A Sniderman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Circulation     Volume:  80     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1989 Dec 
Date Detail:
Created Date:  1990-02-01     Completed Date:  1990-02-01     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1636-41     Citation Subset:  AIM; IM    
Division of Cardiology, Royal Victoria Hospital, Montreal, Quebec, Canada.
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MeSH Terms
Exercise / physiology*
Exercise Test
Follow-Up Studies
Middle Aged
Myocardial Infarction / mortality*,  physiopathology
Proportional Hazards Models
Risk Factors
Stroke Volume / physiology*
Survival Rate
Time Factors

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

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