TY - JOUR
T1 - Predischarge exercise radionuclide angiography in predicting multivessel coronary artery disease and subsequent cardiac events after thrombolytic therapy for acute myocardial infarction
AU - Zhu, Wei Xi
AU - Gibbons, Raymond J.
AU - Bailey, Kent R.
AU - Gersh, Bernard J.
PY - 1994/9/15
Y1 - 1994/9/15
N2 - The value of exercise testing in postinfarction patients receiving thrombolytic therapy has not been established. Ninety-four patients treated acutely with thrombolytic therapy without angioplasty who underwent exercise radionuclide angiography and coronary angiography before hospital discharge were studied. Thirty patients underwent early revascularization, often for multivessel disease. During a median follow-up period of 3.5 years, only 5 patients had "hard" events (cardiac death, cardiac arrest, or myocardial infarction) and 5 other patients underwent late (>90 days) revascularization. The results of radionuclide angiography did not predict multivessel disease. Peak exercise ejection fraction was the only significant (p = 0.003) independent predictor of events. Among the 65 patients with a peak exercise ejection fraction ≥40%, the 3-year hard and "combined" event-free survival were 98% and 91%, respectively. Among the 29 patients with a peak exercise ejection fraction <40%, the 3-year hard and combined event-free survival were 74% and 69%, respectively. Postinfarction patients treated with thrombolytic therapy, who often underwent early revascularization, had an excellent prognosis through 3.5 years of follow-up. Although exercise radionuclide angiography had little value for identifying multivessel disease, a reduced peak exercise ejection fraction was associated with subsequent events.
AB - The value of exercise testing in postinfarction patients receiving thrombolytic therapy has not been established. Ninety-four patients treated acutely with thrombolytic therapy without angioplasty who underwent exercise radionuclide angiography and coronary angiography before hospital discharge were studied. Thirty patients underwent early revascularization, often for multivessel disease. During a median follow-up period of 3.5 years, only 5 patients had "hard" events (cardiac death, cardiac arrest, or myocardial infarction) and 5 other patients underwent late (>90 days) revascularization. The results of radionuclide angiography did not predict multivessel disease. Peak exercise ejection fraction was the only significant (p = 0.003) independent predictor of events. Among the 65 patients with a peak exercise ejection fraction ≥40%, the 3-year hard and "combined" event-free survival were 98% and 91%, respectively. Among the 29 patients with a peak exercise ejection fraction <40%, the 3-year hard and combined event-free survival were 74% and 69%, respectively. Postinfarction patients treated with thrombolytic therapy, who often underwent early revascularization, had an excellent prognosis through 3.5 years of follow-up. Although exercise radionuclide angiography had little value for identifying multivessel disease, a reduced peak exercise ejection fraction was associated with subsequent events.
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U2 - 10.1016/0002-9149(94)90743-9
DO - 10.1016/0002-9149(94)90743-9
M3 - Article
C2 - 8074037
AN - SCOPUS:0028137032
SN - 0002-9149
VL - 74
SP - 554
EP - 559
JO - The American Journal of Cardiology
JF - The American Journal of Cardiology
IS - 6
ER -