Abstract
96 patients, under 70 years of age, underwent symptom-limited (maximal) exercise testing in the 3rd week after an acute myocardial infarction when neither cardiac insufficiency, angina pectoris (post-infarction) nor malignant arrhythmias were present. A further 29 patients, who could not be exercised because of the reasons mentioned, had a significantly higher frequency of coronary events during the 14 month observation period than those patients who could be exercised (55% vs. 23%, P = 0.05). When signs of (reversible) ischaemia occurred during exercise testing (angina pectoris, ST-segment depression greater than 0.1 mV), the one-year prognosis was significantly worse than in patients having no ischaemia. By means of this test the occurrence of a "coronary event" can be forecasted with high sensitivity (92%) but low specificity (46%). Thus, the negative test ("predictive value" 94%) is suitable for recognising patients with low spontaneous risk thus sparing them from further invasive investigations.
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