THE PROGNOSTIC VALUE OF EXERCISE TESTING EARLY AFTER MYOCARDIAL-INFARCTION IN PATIENTS TREATED WITH THROMBOLYTICS

Exercise testing early post AMI was evaluated as a predictor of reinfa rction in patients treated with thrombolytics. AMI patients e, exercis e-tested prior to discharge were included in the study (n=178). The pa tients were followed for 2.9 +/- 0.9 years (mean +/- 1 SD) for the dev elopment of new cardiac events defined as cal cline death or reinfarct ion. Cox regression analysis of clinical and exercise test variables s howed that there was significant predictive value of treating heart fa ilure with drugs from two or more therapeutic groups (P<0.001, hazard ratio 9.4 (3.1-28.2) (estimate and 95% confidence interval)), such as those with a previous history of myocardial infarction (P=0.001; hazar d ratio 4.0 (1.7-9.6)) and of significant ST depression (P=0.029; haza rd ratio 2.5 (1.1-5.7)). Significant ST depression could be substitute d by the Delta ST/Delta HR index (P=0.042; hazard ratio 2.8 (1.2-6.8)) . The exercise test had independent but limited prognostic value in AM I patients treated with thrombolytics. The Delta>ST/Delta HR index did not improve the predictive value of the exercise test.