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Prognosis in patients with a strongly positive exercise electrocardiogram
P Bogaty1, G R Dagenais, B Cantin
1Quebec Heart Institute, Ste-Foy, Canada.
The American Journal of Cardiology
|December 1, 1989
Summary
Exercise test workload predicts survival but not acute cardiac events in patients with positive stress tests. Higher achieved workloads correlate with better survival, but not with reduced risks of nonfatal events like unstable angina or myocardial infarction.
Area of Science:
- Cardiology
- Exercise Physiology
- Preventive Cardiology
Background:
- Positive exercise electrocardiograms (ECG) identify patients at risk.
- Workload achieved during exercise testing is linked to survival rates.
Purpose of the Study:
- To assess if exercise test workload predicts acute ischemic heart events.
- To evaluate prediction of unstable angina and myocardial infarction.
Main Methods:
- 241 medically treated patients with positive exercise ECG (≥2 mm ST depression).
- Bruce protocol treadmill test and coronary angiography.
- 8-year follow-up for mortality and nonfatal acute events.
Main Results:
- Survival improved with higher exercise workloads (Stage I: 45% vs. Stage IV+: 93% 8-year survival).
- Exercise duration, narrowed arteries, and LV abnormalities predicted survival.
- Nonfatal events occurred across all exercise stages; exercise test and angiographic findings did not predict these events.
Conclusions:
- Exercise test workload effectively stratifies mortality risk in patients with positive stress tests.
- Workload achieved during exercise testing does not predict the occurrence of nonfatal acute ischemic events.