Document Detail

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.
MedLine Citation:
PMID:  8421973     Owner:  NLM     Status:  MEDLINE    
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)
H Mickley; P Pless; J R Nielsen; J Berning; M Møller
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  71     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1993 Jan 
Date Detail:
Created Date:  1993-02-18     Completed Date:  1993-02-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  139-44     Citation Subset:  AIM; IM    
Department of Cardiology B, Odense University Hospital, Denmark.
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MeSH Terms
Electrocardiography, Ambulatory
Exercise Test*
Exercise Tolerance / physiology
Follow-Up Studies
Middle Aged
Myocardial Infarction / epidemiology*
Myocardial Ischemia / diagnosis,  epidemiology*
Stroke Volume / physiology
Time Factors
Ventricular Function, Left / physiology

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