Document Detail

Seven-year prognostic value of the electrocardiogram at rest and an exercise test in patients admitted for, but without, confirmed myocardial infarction.
MedLine Citation:
PMID:  8472713     Owner:  NLM     Status:  MEDLINE    
The seven-year prognosis for cardiac events (non-fatal acute myocardial infarction (AMI) or cardiac death) following discharge was related to an electrocardiogram (ECG) at rest and a symptom-limited exercise test in 217 patients admitted with chest pain without confirmed AMI. The follow-up time was 86-98 months, median 88 months. Although the 7-year prognosis was better than in a comparable group of patients with AMI (P < 0.0001), the frequency of cardiac events was still very high. Patients with negative T waves, ST depression or elevation, intraventricular block or Q waves at rest, ST abnormalities during exercise or both constituted a high-risk group. In patients without these ECG abnormalities the prognosis was significantly better (P << 0.0001). The percentages without cardiac events after 7 years were 53 and 92 respectively. Patients with a low rise in the rate-pressure product indicative of decreased function of the left ventricle and patients who developed angina pectoris during exercise also had a significantly impaired 7-year prognosis. This non-invasive approach to risk stratification identified a group of non-AMI patients with a high risk for cardiac events, and a group comprising more than 50% of the patients with a very low risk.
P Fruergaard; J Launbjerg; H L Jacobsen; J K Madsen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  14     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1993 Apr 
Date Detail:
Created Date:  1993-05-20     Completed Date:  1993-05-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  499-504     Citation Subset:  IM    
Medical Department B, Frederiksborg County Central Hospital, Hillerød, Denmark.
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MeSH Terms
Death, Sudden, Cardiac / epidemiology*
Exercise Test
Follow-Up Studies
Middle Aged
Myocardial Infarction / diagnosis,  epidemiology*
Predictive Value of Tests
Prospective Studies
Risk Factors
Time Factors

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