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Early Post-myocardial Infarction Treadmill Stress Testing: An Accurate Predictor of Multivessel Coronary Disease and Subsequent Cardiac Events

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.; and RICHARD R. MILLER, M.D.
[+] Article and Author Information

This paper was presented in part at the 29th Annual Scientific Sessions of the American College of Cardiology, 9 March 1980, in Houston, Texas.

▸Requests for reprints should be addressed to Albert E. Raizner, M.D.; Section of Cardiology, The Methodist Hospital, 6516 Bertner Boulevard; Houston, TX 77030.


Houston, Texas


© 1981 American College of PhysiciansAmerican College of Physicians


Ann Intern Med. 1981;94(6):734-739. doi:10.7326/0003-4819-94-6-734
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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.

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