Copyright © 1993 by the European Society of Cardiology.
© 1993 The European Society of Cardiology
Prognostic significance of silent myocardial ischaemia during maximal exercise testing after a first acute myocardial infarction
From the Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique Lille, France
Received 29 January 1993; revised 20 May 1993; .
Correspondence: M. E. Bertrand, MD, Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, Boulevard du Professeur J Leclercq, 59037 Lille Cedex, France
Abstract
Clinical, exercise, and angiographic variables, and long-term follow-up were compared in patients, who, during maximal Bruce exercise testing after a first acute myocardial infarction (AMI), had positive responses to exercise testing (n = 116, 38% of 303) with (n % 23, group I) or without (n = 93, group II) angina. Group I patients more often (52 vs 19%, P < 0.001) had a history of pre-infarction angina. Group II had a greater proportion (75 vs 52%, P < 0.05) of inferior wall AMI, whereas group I had a greater proportion (30 vs 19%, P < 0.01) of non-Q wave AMI. Total exercise duration was significantly (P < 0.01) longer in group II (7.6 ± 3.2 vs 5.5 ± 3.1 min). Maximal exercise heart rate (144 ± 22 vs 133 ± 21, beats . min–1 P < 0.05 was also higher in group II. A greater proportion of group II patients (37 vs 9%, P < 0.05) had single-vessel disease, whereas multivessel disease was more common (91 vs 63% P < 0.03) in group I. Left ventricular function was similar in both groups. During follow-up (48 ± 22 months) the incidence of cardiac death (group I, 3.3%, group II, 4.8%), of recurrent infarction (group I, 4.8%, group II 3.3%), and of revascularization procedures (group I, 28.5%, group II, 19.8%) were similar in both groups. Although asymptomatic exercise-induced ischaemia was associated with better exercise performance and less extensive coronary disease than symptomatic ischaemia, it had the same long-term prognostic implications.
Key Words: Acute myocardial infarction • silent ischaemia • coronary atherosclerosis • exercise testing
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  P. Erne, A. W. Schoenenberger, D. Burckhardt, M. Zuber, W. Kiowski, P. T. Buser, P. Dubach, T. J. Resink, and M. Pfisterer Effects of Percutaneous Coronary Interventions in Silent Ischemia After Myocardial Infarction: The SWISSI II Randomized Controlled Trial JAMA, May 9, 2007; 297(18): 1985 - 1991. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. J. Zellweger, M. Weinbacher, A. W. Zutter, R. V. Jeger, J. Mueller-Brand, C. Kaiser, P. T. Buser, and M. E. Pfisterer Long-term outcome of patients with silent versus symptomatic ischemia six months after percutaneous coronary intervention and stenting J. Am. Coll. Cardiol., July 2, 2003; 42(1): 33 - 40. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H Dominguez, C Torp-Pedersen, L Koeber, and C Rask-Madsen Prognostic value of exercise testing in a cohort of patients followed for 15 years after acute myocardial infarction Eur. Heart J., February 2, 2001; 22(4): 300 - 306. [Abstract] [PDF]
|
|