Related Experiment Videos
Risk stratification after myocardial infarction: targets and tools
1Division of Cardiology, Ospedale di Careggi, Firenze, Italy.
Echocardiography (Mount Kisco, N.Y.)
|April 8, 1995
Summary
In the interventional era of myocardial infarction (MI), noninvasive risk stratification before hospital discharge appears effective for uncomplicated cases. This approach may obviate the need for routine coronary angiography in many patients.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiovascular Medicine
Background:
- The management of myocardial infarction (MI) has entered an
Purpose of the Study:
- To evaluate risk stratification strategies for patients with uncomplicated myocardial infarction (MI) before hospital discharge.
- To compare the effectiveness of noninvasive testing versus routine coronary angiography in predicting post-discharge cardiac events.
Main Methods:
- Review of clinical trial data (TIMI-2 and SWIFT) comparing conservative (noninvasive testing) and routine angiography approaches.
- Empirical validation of predischarge risk stratification using stress testing and clinical assessment.
Main Results:
- An excellent 1-year outcome was observed in patients managed with a conservative, noninvasive approach.
- Routine coronary angiography did not demonstrate improved outcomes compared to a selective, noninvasive strategy.
Conclusions:
- Predischarge risk stratification using noninvasive tests and clinical assessment is a validated approach for uncomplicated MI.
- Highly predictive noninvasive tests could potentially eliminate the need for routine coronary angiography after MI.