Document Detail

The prognostic significance of exercise-induced silent ST-segment depression in patients after myocardial infarction.
MedLine Citation:
PMID:  8464140     Owner:  NLM     Status:  MEDLINE    
To evaluate the prognostic value of exercise-induced silent ST-segment depression, 157 patients who had suffered myocardial infarction underwent symptom-limited exercise testing and coronary angiography. Patients were divided into 3 groups according to the presence or absence of ischemic ST-segment depression and angina during exercise testing. Group A patients had ST-segment depression without angina. Group B patients had both ST-segment depression and angina. Group C patients had neither ST-segment depression nor angina. All patients were followed without coronary artery bypass graft or percutaneous transluminal coronary angioplasty for an average of 36 months and the frequency of coronary events (cardiac death, recurrent myocardial infarction and unstable angina pectoris) was compared. Group A patients had less severe coronary artery disease, greater coronary reserve during exercise and exercised longer than group B. However, the prognosis of group A was similar to group B, and was worse than group C. Using the Cox proportional hazards model, ischemic ST-segment depression was the most useful index for predicting future coronary events among the baseline values, coronary angiographic and exercise testing variables. However, angina during exercise testing was not an independent predictor. Thus, post-infarction patients showing exercise-induced ST-segment depression should be treated carefully regardless of the presence or absence of angina.
T Toyoda; T Takeuchi; T Uchiyama; H Sato; N Takahashi; T Miura; C Ibukiyama
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  57     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1993 Mar 
Date Detail:
Created Date:  1993-05-06     Completed Date:  1993-05-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  197-207     Citation Subset:  IM    
Second Department of Internal Medicine, Tokyo Medical College, Japan.
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MeSH Terms
Coronary Angiography
Exercise / physiology*
Exercise Test
Middle Aged
Myocardial Infarction / physiopathology*
Myocardial Ischemia / diagnosis
Severity of Illness Index

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