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Multi variate long term prognostic index from exercise electro cardiogram after acute myo cardial infarction

Multi variate long term prognostic index from exercise electro cardiogram after acute myo cardial infarction

European Journal of Cardiology 11(6): 435-444

From a symptom-limited bicycle exercise test 3 wk after acute myocardial infarction, [AMI] in 205 patients the prognostic significance for the 1 yr prognosis of the following variables was examined by a multivariate analysis (Cox's model): reasons for stopping, duration of work, maximal heart rate, maximal product heart rate .times. systolic blood pressure, maximal ST-deviation, time to maximal ST-deviation and ventricular ectopic beats (type and frequency). The reason for stopping was fatigue in 59% and angina pectoris in 15%; 48% exercised up to 6 min and 14% beyond 12 min, with median duration of 7 min. The maximal heart rate was > 140/min in 30%. ST-deviations were found in 77%; in most patients < 3 mm, 44% had ventricular ectopic beats during the exercise. The only significant variable was the duration of work with prognostic index for the 1 yr prognosis. A probability of survival of > 0.95 after 1 yr required a duration of work of > 13 min. The observed deaths agreed with the expectation with a little overestimation; 75% died from a definite cardial cause. There is a good predictive value for the 1-yr prognosis of the duration of work from an exercise test 3 wk after AMI.

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