OBJECTIVES - To evaluate the role of non-invasive tests to identify patients at risk of recurrent ischemic events (unstable angina, myocardial infarction, death) after acute myocardial infarction. PATIENTS AND METHODS - Predischarge left ventricular ejection fraction (LVEF), late potential (LP), 24-hour Holter monitoring and limited exercise stress ECG test were evaluated in patients after acute myocardial infarction. Exclusion criteria from the study were ECG evidence of left ventricular hypertrophy with strain pattern, left bundle branch block, permanent pacemaker, NYHA class III-IV heart failure, angina and musculoskeletal problems hindering exercise ECG test. 55 patients underwent each test and were followed for 12 month. RESULTS - Recurrent ischaemic events occurred in 18 patients (unstable angina 16, myocardial infarction 1, death 1). The correlation of event positivity and test results were analyzed with Eischer's exact test. There was no prognostic value provided by LVEF (p=0.753), Holter monitoring (p=0.212), and LP (p=0.534). The poor discriminative value of LVEF may have been caused by the relatively good left ventricular function (LVEF 49±10%) in these patients. Limited exercise stress ECG test was the only significant predictor (p=0.001). CONCLUSION - In postinfarction patients with no symptomatic angina and good left ventricular function early limited exercise stress ECG proved to be of prognostic value, while LP and Holter monitoring were not cost effective.
|Translated title of the contribution||Prognostic importance of non-invasive tests early after myocardial infarction|
|Number of pages||5|
|Journal||Lege Artis Medicinae|
|Publication status||Published - dec. 1 1998|
- Myocardial infarction
ASJC Scopus subject areas