| Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up. | |
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MedLine Citation:
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PMID: 8421973 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory recording 11 +/- 5 days after AMI 23 patients (19%) had 123 ischemic episodes (group 1), whereas 100 patients demonstrated no ischemia (group 2). Exercise-induced ST-segment depression was more prevalent in group 1 (83%) than in group 2 (47%) (p < 0.005). Group 1 patients also had more severe ischemia as judged from a shorter exercise duration before significant ST-segment depression (5.5 +/- 2.4 vs 7.7 +/- 4.1 minutes; p < 0.03) and more pronounced ST-segment depression on exercise testing (4.1 +/- 2.6 vs 2.6 +/- 1.6 mm; p < 0.03). Furthermore, exercise test results revealed an impaired hemodynamic response in group 1 compared with group 2: systolic blood pressure at maximal work load 160 +/- 31 vs 176 +/- 28 mm Hg (p < 0.025) and systolic blood pressure increase during exercise 41 +/- 24 vs 56 +/- 22 mm Hg (p < 0.01). With-in 368 +/- 8 days of follow-up the frequency of cardiac events (cardiac death, nonfatal reinfarction, and severe angina including the need of revascularization) was 52% in group 1 compared with 22% in group 2 (p < 0.01). Exercise-induced ischemia did not predict an adverse outcome: event rate 30 vs 25% in patients without residual ischemia (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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H Mickley; P Pless; J R Nielsen; J Berning; M Møller |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of cardiology Volume: 71 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1993 Jan |
Date Detail:
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Created Date: 1993-02-18 Completed Date: 1993-02-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 139-44 Citation Subset: AIM; IM |
Affiliation:
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Department of Cardiology B, Odense University Hospital, Denmark. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Echocardiography Electrocardiography, Ambulatory Exercise Test* Exercise Tolerance / physiology Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / epidemiology* Myocardial Ischemia / diagnosis, epidemiology* Prognosis Stroke Volume / physiology Time Factors Ventricular Function, Left / physiology |
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