Early Exercise Test in Acute Myocardial Infarction Treated with Intravenous Streptokinase

Abstract

The aim of this study was to assess the value of the early exercise test (ET) in patients with acute myocardial infarction (AMI) treated with IV streptokinase (SK). The authors studied 70 patients with first AMI; 31 were treated with SK and 39 were not. Before discharge everyone was given early exercise up to 5-6 METs and catheterized within 22.9 +/- 7.2 days. There was no significant difference in the number of positive ETs between the two groups (11/31 and 14/39 respectively). There was significant difference in favor of: (1) the recanalization of the infarct-related artery in the SK group, (2) the negative ET in patients with recanalized vessels in both groups, (3) the positive ET in patients with multi-vessel coronary disease. It is concluded that the results of early ET in patients with AMI are related to the recanalization of the infarct-related artery and the coexistence of multi-vessel coronary artery disease, regardless of SK treatment. Patients with successful thrombolysis have negative ET more frequently.

Safety and diagnostic accuracy of stress cardiac magnetic resonance imaging vs exercise tolerance testing early after acute ST elevation myocardial infarction

“…Other patients should have an exercise tolerance test (ETT) in the hospital or early after discharge to assess the presence and extent of inducible ischaemia (class 1 evidence), or a stress imaging study if baseline ECG abnormalities compromise interpretation of the ETT 7. However, although widely available and cost-effective, ETT has important and well known limitations in terms of diagnostic accuracy 8 – 10…”