Incidence and prognostic significance of symptomatic and asymptomatic exercise-induced ischemia in patients with recent myocardial infarction

Cristina Opasich, Franco Cobelli, Jole Assandri, Giuseppe Calsamiglia, Oreste Febo, Maria Teresa Larovere, Massimo Pozzoli, Roberto Tramarin, Egidio Traversi, Diego Ardissino, Giuseppe Specchia

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Abstract

To determine the incidence and the significance of anginal chest pain during abnormal exercise testing (↙ S-T ≥ 0.1 mV) in patients with recent myocardial infarction we reviewed a series of 353 patients who underwent maximal bicycle exercise stress 4-8 weeks following acute myocardial infarction. Of the 353 patients, 26 had ischemic ECG changes and chest pain (group A); 85 patients had ischemic ECG changes but no chest pain (group B). The two groups differ significantly only in the frequency of a history of typical angina pectoris more than 6 months prior to acute myocardial infarction (group A 42.3% vs. group B 15.2%, p <0.01). Typical chest pain is more frequent in anterior versus inferior myocardial infarction (50 vs. 14.4%. p <0.001). The patients were followed up for 28.8 ± 8.7 months with clinical and exercise testing controls. The incidence of exertional angina during the follow-up was significantly more frequent in group A patients than in group B patients (80.7 vs. 24.7%, p <0.001). Unstable angina pectoris was more frequent in group A (34.6 vs. 11.8%, p <0.01). There was no statistically significant difference in mortality (group A 3.8% vs. group B 5.9%) and cardiac events (group A 3.8% vs. group B 5.9%) between the two groups. Thus, we concluded that the occurrence of anginal pain associated with S-T segment depression during exercise testing does not increase the prognostic risk.

Original languageEnglish
Pages (from-to)284-291
Number of pages8
JournalCardiology
Volume71
Issue number5
Publication statusPublished - 1984

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Keywords

  • Anginal pain
  • Exercise testing
  • Exertional myocardial ischemia
  • Myocardial infarction

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

Cite this

Opasich, C., Cobelli, F., Assandri, J., Calsamiglia, G., Febo, O., Larovere, M. T., Pozzoli, M., Tramarin, R., Traversi, E., Ardissino, D., & Specchia, G. (1984). Incidence and prognostic significance of symptomatic and asymptomatic exercise-induced ischemia in patients with recent myocardial infarction. Cardiology, 71(5), 284-291.