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[Prognostic value of the exercise test in patients with ischemic heart disease]
J C Necoechea Alva1, P Camacho Jiménez, D Gil
1Hospital de Cardiología Los Méndez del Centro Médico Nacional, Instituto Mexicano del Seguro Social, D.F.
Insights
Stress testing effectively predicts prognosis in coronary heart disease patients. Limited exercise capacity and significant ST-T changes on stress tests indicate higher annual mortality risk.
Area of Science:
- Cardiology
- Clinical Medicine
- Diagnostic Testing
Context:
- Coronary heart disease (CHD) poses significant mortality and morbidity risks.
- Accurate prognostic tools are crucial for managing patients with established CHD.
- Stress testing is a common diagnostic modality in cardiology.
Purpose:
- To evaluate the prognostic value of stress testing in patients with coronary heart disease (CHD).
- To identify specific stress test parameters associated with adverse outcomes in CHD patients.
Summary:
- This study followed 95 CHD patients (average age 52) for 33 months, assessing outcomes based on stress test results.
- Patients with limited exercise ability (≤3 minutes) or significant ST-T changes (≥0.2 mV) on stress tests exhibited higher annual mortality rates (13.6% and 7% respectively).
- Annual mortality was 3.8%, primarily in patients with prior myocardial infarction, with deaths linked to poor exercise tolerance and severe ST-T abnormalities.
Impact:
- Stress testing provides valuable prognostic information for patients with coronary heart disease.
- Identifying high-risk patients through stress test parameters can guide clinical management and intervention strategies.
- These findings support the use of stress testing in risk stratification for CHD patients.
Abstract:
The objective of this study is to determine the prognostic value of stress testing in patients with coronary heart disease. We examined 95 cases followed during an average period of 33 months. The age was 52 +/- 9 years. All patients had clinical evidence of myocardial ischemia: 78 had previous myocardial infarction, 11 stable angor pectoris and six unstable angina. After the initial event 33 patients were asymptomatic and 62 with mild angina. During follow-up; 42 patients had no coronary events; 10 died, six developed non-fatal myocardial infarction and 37 had more angina, nine of these patients were treated with bypass coronary artery surgery. The annual mortality was 3.8%, all with previous myocardial infarction. In the stress testing the patients who died were distinguished by limited exercise ability and severe changes of ST-T segment. Patients with greater than or equal to 0.2 mV ST-T segment depth or effort duration less than or equal to 3 minutes had an annual mortality F 7% 13.6% respectively.