Early exercise test for evaluation of long-term prognosis after uncomplicated myocardial infarction.

Abstract

The prognostic value of early load-limited exercise testing has been assessed in 200 men younger than 66 years three weeks after uncomplicated myocardial infarction. Positive criteria of the test were: typical angina, ischemic ST depression λ 0.1 mV, increase in heart rdte of 35 beats/min or more above the resting heart rate, poor systolic blood pressure rise (< 5 mm Hg) and malignant ventricular premature beats. No complications of exercise testing were noted.The prognostic value of the positive test and of the different positive criteria independently predicting cardiac mortality was studied during a follow-up of three months to six years (mean three years and one month). The positive test was predictive of cardiac mortality (P <0.005). Exercise angina (P <0.05), ischemic ST depression (P < 0.005) and excessive increase in heart rate (P < 0.01) were also predictive of mortality, whereas a poor systolic blood pressure rise and malignant premature beats were not. We conclude that patients without complications three weeks after acute myocardial infarction can safely perform load-limited exercise testing and that the prognostic value of this test during the succeeding years is considerable.