Early ischemia, defined as angina with transient ST-T .0027), and previous angina (p = .017). Extension of the infarction during hospitalization was diagnosed in 31 patients (7% of the total population) and could be independently predicted only by the presence of early ischemia: it occurred in 22 of the 79 patients with ischemia (28%) vs nine of 370 without (2.4%, p < .0001). During a mean follow-up of 14 ± 8 months (2 to 28), cumulative survival was 83% in patients with early ischemia and 92% in those without (p = .01); survival without MI was 67% vs 81%, respectively. Thus, early ischemia after MI is a frequent finding that is clinically predictable. It is associated with more severe coronary artery disease and identifies, independently of non-Q wave MI and of extent of coronary artery disease, a group at high risk for MI extension in hospital and for cardiac events during follow-up. Circulation 75, No. 5, 988-995, 1987.