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Circulation, Vol 70, 547-551, Copyright © 1984 by American Heart Association
PL McHenry, J O'Donnell, SN Morris and JJ Jordan
A group of 916 apparently healthy men between the ages of 27 and 55 years
(mean 37) were followed up with serial medical and exercise test
evaluations for a period of 8 to 15 years (mean 12.7) to determine (1) the
prevalence and specific types of new coronary events observed in subjects
with and without abnormal ST segment responses to exercise and (2) the
predictive value of a serial conversion to an abnormal ST segment response
to exercise for new coronary events. During the initial evaluation there
were 23 subjects (2.5%) with an abnormal ST segment response to exercise.
During follow-up there were nine (39%) coronary events in this group: eight
cases of angina and one of sudden death. With serial testing, an additional
38 subjects (5.1%) experienced conversion to an abnormal ST segment
response to exercise. During follow-up there were 12 (32%) coronary events
in this group: 10 cases of angina, one of myocardial infarction, and one
other. There were 833 subjects with normal ST segment responses to exercise
with all tests. In this group there were 44 (5.3%) coronary events: 25
cases of myocardial infarction, seven of sudden death, and 12 of angina. We
conclude that in apparently healthy middle-aged men an abnormal ST segment
response to exercise is predictive of angina pectoris but not of myocardial
infarction or sudden cardiac death as an initial coronary event.
ARTICLES
The abnormal exercise electrocardiogram in apparently healthy men: a predictor of angina pectoris as an initial coronary event during long- term follow-up
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