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Survival with painless strongly positive exercise electrocardiogram.
G R Dagenais1, J R Rouleau, P Hochart
1Department of Medicine, Laval University, Quebec, Canada.
The American Journal of Cardiology
|November 1, 1988
Summary
Patients with painless positive exercise electrocardiograms have a good prognosis, with a 6-year survival rate of 85%. However, exercise duration is a key factor in predicting survival for these individuals.
Area of Science:
- Cardiology
- Exercise Physiology
Background:
- A positive exercise electrocardiogram (ECG) indicates potential coronary artery disease (CAD).
- The prognostic significance of a painless positive exercise ECG requires further clarification.
Purpose of the Study:
- To evaluate the long-term prognosis of patients with painless, strongly positive exercise ECG results.
- To compare survival rates based on the presence or absence of angina during exercise testing.
Main Methods:
- A 6-year survival analysis was conducted on 298 medically treated patients with horizontal or downsloping ST depression (≥2 mm) on treadmill exercise tests.
- Patients were stratified based on whether they terminated the test due to dyspnea/fatigue (without angina) or angina.
Main Results:
- The 6-year survival rate was 85% ± 3% for patients without angina and 80% ± 3% for those with angina (p<0.05).
- Patients without angina demonstrated longer exercise duration, higher maximal heart rate, and higher systolic blood pressure.
- Survival decreased with shorter exercise durations in both groups, particularly in patients without angina.
Conclusions:
- Painless positive exercise ECGs generally indicate a favorable prognosis, but angina during exercise may slightly increase mortality risk.
- Exercise capacity, as measured by exercise duration and workload, is a critical determinant of survival in patients with positive exercise ECGs.