[A prospective study of future cardiac events in subjects who underwent treadmill exercise testing]

The prognostic value of the exercise testing as well as coronary risk factors was assessed in 890 patients (pts) with a history of myocardial infarction (MI, n = 114) or chest pain (typical angina; TA, n = 134, others; OTH, n = 642) in relation to cardiac events (cardiac death, non-fatal MI). Clinical questionnaires and symptomatic-maximal graded treadmill exercise were performed in all pts. Follow-up was obtained prospectively by mail or telephone interview annually. Twenty eight pts were lost to follow-up. In the remaining 862 pts (96.9%), the mean follow-up duration was 3.1 +/- 1.4 (mean +/- SD) years. During follow-up period, 39 cardiac events (21 cardiac death, 18 non-fatal MI) (4.5%) occurred. Cardiac event rates in pts with MI, TA, and OTH were 16.2%, 9.8%, and 1.3%, respectively. Univariate analyses revealed that the event rate was influenced by age, sex (male), hypertension, diabetes mellitus, and HDL-cholesterol among coronary risk factors, and by anginal pain during exercise, ST depression, poor exercise tolerance, and abnormal blood pressure response among treadmill exercise findings. By Cox proportional hazard model analysis, the history of MI, age, TA, and ST depression (within 6 minutes of Bruce protocol) was significantly independent predictors for future cardiac events in all pts; and age, sex, and TA in pts without MI. In conclusion, the exercise testing combined with conventional coronary risk factor analysis was effective means in predicting future cardiac events.