ANGINA-PECTORIS AND ST-SEGMENT DEPRESSION DURING EXERCISE TESTING EARLY FOLLOWING ACUTE MYOCARDIAL-INFARCTION

This study evaluates the prognostic value of ST-segment depression and angina pectoris occurring alone or in combination during exercise tes ting performed 3 weeks after myocardial infarction in 281 of 570 conse cutive survivors of acute myocardial infarction. Neither angina pector is (36 patients) nor ST-segment depression of at least 1 mm (46 patien ts) correlated with the occurrence of acute coronary events (cardiac d eath, myocardial infarction, unstable angina pectoris requiring hospit alization) during the subsequent year. Even a small group of patients (n = 13) with both angina and ST-segment depression did not suffer a h igher occurrence of acute events. However, the presence of angina and/ or ST-segment depression was strongly correlated with the subsequent p erformance of coronary arteriography. This study indicates that acute coronary events cannot be predicted by clinical or ECG evidence of myo cardial ischemia during exercise tests performed 3 weeks after acute m yocardial infarction.