Early exercise testing following percutaneous transluminal coronary angioplasty

The value of early symptom-limited stress electrocardiography following percutaneous transluminal coronary angioplasty in assessing late outcome was evaluated in 218 patients. All subjects were tested using the Bruce or Sheffield Protocols, 2.5 +/- 1.3 days after percutaneous transluminal coronary angioplasty. Repeat coronary angiography was performed after percutaneous transluminal coronary angioplasty because of symptoms (58%) or as routine follow-up (42%). Stress electrocardiography results were compared to coronary angiography. The sensitivity and specificity were 35.3% and 52.6%, respectively. The positive and negative predictive values were 39.6% and 48.0%. Two acute myocardial infarctions and one coronary angiographic-proven restenosis occurred within hours of the stress electrocardiogram in three patients (1.4%). It is concluded that symptom-limited stress testing immediately following percutaneous transluminal coronary angioplasty has no prognostic value and may carry increased risk for immediate negative coronary events.