Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up

H Mickley, P Pless, J R Nielsen, J Berning, M Møller

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

The relation between early out-of-hospital ambulatory ST-segment monitoring, clinical characteristics, predischarge maximal exercise testing and cardiac events was determined in 123 consecutive men (age 55 +/- 8 years) with a first acute myocardial infarction (AMI). During 36 hours of ambulatory recording 11 +/- 5 days after AMI 23 patients (19%) had 123 ischemic episodes (group 1), whereas 100 patients demonstrated no ischemia (group 2). Exercise-induced ST-segment depression was more prevalent in group 1 (83%) than in group 2 (47%) (p < 0.005). Group 1 patients also had more severe ischemia as judged from a shorter exercise duration before significant ST-segment depression (5.5 +/- 2.4 vs 7.7 +/- 4.1 minutes; p < 0.03) and more pronounced ST-segment depression on exercise testing (4.1 +/- 2.6 vs 2.6 +/- 1.6 mm; p < 0.03). Furthermore, exercise test results revealed an impaired hemodynamic response in group 1 compared with group 2: systolic blood pressure at maximal work load 160 +/- 31 vs 176 +/- 28 mm Hg (p < 0.025) and systolic blood pressure increase during exercise 41 +/- 24 vs 56 +/- 22 mm Hg (p < 0.01). With-in 368 +/- 8 days of follow-up the frequency of cardiac events (cardiac death, nonfatal reinfarction, and severe angina including the need of revascularization) was 52% in group 1 compared with 22% in group 2 (p < 0.01). Exercise-induced ischemia did not predict an adverse outcome: event rate 30 vs 25% in patients without residual ischemia (p = NS).(ABSTRACT TRUNCATED AT 250 WORDS)
Original languageEnglish
JournalAmerican Journal of Cardiology
Volume71
Issue number2
Pages (from-to)139-44
Number of pages5
ISSN0002-9149
Publication statusPublished - 15. Jan 1993

Keywords

  • Echocardiography
  • Electrocardiography, Ambulatory
  • Exercise Test
  • Exercise Tolerance
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction
  • Myocardial Ischemia
  • Prognosis
  • Stroke Volume
  • Time Factors
  • Ventricular Function, Left

Fingerprint Dive into the research topics of 'Transient myocardial ischemia after a first acute myocardial infarction and its relation to clinical characteristics, predischarge exercise testing and cardiac events at one-year follow-up'. Together they form a unique fingerprint.

Cite this