COLIN M. FULLER, M.D.; ALBERT E. RAIZNER, M.D.; MARIO S. VERANI, M.D.; PATRICIA A. NAHORMEK, M.D.; ROBERT A. CHAHINE, M.D.; CHARLES W. McENTEE, M.D.; RICHARD R. MILLER, M.D.
Limited (heart rate to ≤ 120 beats/min) standardized treadmill stress testing was done before hospital discharge in 40 survivors of uncomplicated acute myocardial infarction. Each patient had subsequent coronary arteriography. Twenty-one had inferior, 10, anterior, and nine, nontransmural infarctions; in 30 patients this was their first infarction. A positive electrocardiographic response or angina, or both, occurred in 15 patients and correctly detected most patients with multivessel disease (sensitivity 67%, predictive value 87%) and patients at risk for coronary events: 35% of positive responders admitted for angina in the first month after discharge versus 4% of patients with a negative test (p < 0.05). During a 7-month follow-up period, 73% of patients with a positive test result developed angina versus 16% of those with negative test results (p < 0.001). Thus, predischarge post-myocardial infarction limited stress testing correctly identifies the high-risk subset of patients with multivessel coronary disease and thereby allows intelligent selection of patients for early coronary arteriography.
FULLER CM, RAIZNER AE, VERANI MS, NAHORMEK PA, CHAHINE RA, McENTEE CW, et al. Early Post-myocardial Infarction Treadmill Stress Testing: An Accurate Predictor of Multivessel Coronary Disease and Subsequent Cardiac Events. Ann Intern Med. ;94:734–739. doi: 10.7326/0003-4819-94-6-734
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Published: Ann Intern Med. 1981;94(6):734-739.
Cardiac Diagnosis and Imaging, Cardiology, Coronary Heart Disease, Pulmonary/Critical Care.
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