Exercise testing soon after myocardial infarction: its relation to course and outcome at one year in patients aged less than 55 years.

Abstract

A consecutive series of 184 patients aged less than 55 years who had an acute myocardial infarction were enrolled in a study to examine outcome at one year. One hundred of these patients underwent a maximal exercise test six weeks after infarction to evaluate its ability to predict cardiac events. The in-hospital mortality for the series was 7.6% (14 deaths) and the one year mortality for the 170 survivors was 3.8% (seven deaths). During the exercise test 31 patients had angina and 21 had ST depression. During the one year follow up period 39 of 100 patients had angina on exertion, 15 patients underwent coronary artery surgery, three patients had a reinfarction, and one patient died. Angina during the exercise test but not ST segment depression during the exercise test predicted angina on exertion and the need for coronary artery surgery. In the year of follow up angina occurred during everyday exertion in 25 (81%) (95% confidence interval 62 to 92%) of the 31 patients who developed angina during the exercise test and in only 14 (20%) (95% confidence interval 12 to 32%) of 69 patients who did not, and coronary artery surgery was performed in 11 (35%) (95% confidence interval 19 to 54%) of the 31 patients with angina during the exercise test and only four (6%) (95% confidence interval 2 to 15%) of 69 patients without angina. The outcome after myocardial infarction in patients aged less than 55 years was good and the occurrence of angina, but not ST segment depression, during a maximal exercise test six weeks after infarction was an indication for further investigation.

Prospective study of patients aged 55 years or less with acute myocardial infarction between 1981 and 1985: outcome 7 years and beyond.

“…Other studies (table 6) have tended to report a higher rate of reinfarction, although studies of a similar duration and restricted to patients of a similar age to ours are lacking. Although our rate of recurrent infarction is probably lower than in other studies, the reinfarction rate applies only to patients recruited to the study group and only up to 7 years after infarction.…”

eHEART: www.heartjnl.com

“…Criteria of a positive exercise test have been published previously. 3 A coronary angiogram and left ventriculography were performed at a mean of 3 (range 1-6) months' after MI and reviewed by two independent observers. Stenoses (visualised in at least two orthogonal planes) of greater than 50% intraluminal diameter reduction were considered significant.…”

“…1 Although short and medium term prognosis in young MI survivors is known to be excellent, [2][3][4] little is known about their long term prognosis. This prospective study was carried out over 18 years and investigated the factors that influence the survival of patients with MI stratified by early exercise testing, early angiography, and clinical parameters.…”

A prospective study of long term prognosis in young myocardial infarction survivors: the prognostic value of angiography and exercise testing

“…urvival after myocardial infarction (MI) is influenced by multiple factors, of which age stands out as a major nonmodifiable predictor of long term prognosis. 1 Although short and medium term prognosis in young MI survivors is known to be excellent, [2][3][4] little is known about their long term prognosis. This prospective study was carried out over 18 years and investigated the factors that influence the survival of patients with MI stratified by early exercise testing, early angiography, and clinical parameters.…”