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Circulation, Vol 64, 306-314, Copyright © 1981 by American Heart Association
FM Weld, KL Chu, JT Bigger Jr and LM Rolnitzky
We enrolled 250 patients with acute myocardial infarction after they had
been discharged from the cardiac intensive care unit. Among 236 patients
who performed a low-level exercise test just before hospital discharge, 52
(22%) had exercise-induced ST depression of at least 0.1 mV in ECG lead V5,
102 (43%) had ventricular arrhythmias, and 121 (51%) had an exercise
capacity of shorter than 6 minutes. We used multiple logistic regression
analysis to investigate the association of exercise variables with 1-year
cardiac mortality. Exercise duration and ventricular premature
depolarizations (VPDs) were significantly associated with 1-year mortality
after acute myocardial infarction, both with and without control of the
influence of other exercise variables statistically; the association of
exercise-induced ST depression with 1-year cardiac mortality was not
statistically significant. Standardized regression coefficients showed that
the variables ranked in the following order in terms of predictive value:
exercise duration, VPD frequency and ST depression. Jackknife techniques
showed that multiple logistic regression using the three exercise variables
was highly accurate in predicting 1-year mortality.
ARTICLES
Risk stratification with low-level exercise testing 2 weeks after acute myocardial infarction
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