Comparison of Maximum Versus Submaximum Exercise Testing in Providing Prognostic Information After Acute Myocardial Infarction and/or Coronary Artery Bypass Grafting
Section snippets
Patient Group
The study group comprised 584 male patients, referred to an outpatient cardiac rehabilitation program during the period of August 1978 to March 1988, who had a history of myocardial infarction, had undergone coronary bypass surgery, or both. Before entering the program, 527 of these patients performed a graded maximum exercise test, on average 12.9 ± 2.7 weeks after the event: 297 patients after AMI, 119 after CABG, and 111 patients who had both AMI and CABG. The characteristics of these
Clinical Characteristics of the Patients
The characteristics of the 527 patients at the time of entry into the study are shown in Table 1. Ages ranged from 24 to 74 years. Seventy-one patients complained of dyspnea, and 128 patients reported daily chest pain at the time of the evaluation. All patients performed the exercise test until exhaustion, not limited by angina pectoris. Peak oxygen uptake averaged 1,704 ± 464 ml/min, 22.3 ± 6.0 ml/min/kg, or 6.65 ± 1.8 METs, and peak heart rate was 129 ± 23 beats/min. The respiratory gas
Discussion
Many investigators have used clinical and exercise characteristics to predict prognosis in patients with coronary artery disease. Exercise capacity, as estimated by total exercise duration or achieved workload during an exercise test, has been claimed to predict cardiovascular mortality.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17 In many studies, however, submaximum exercise tests until a given workload or heart rate were used in patients with AMI, possibly hypothecating an
Acknowledgements
The kind cooperation of Jos Willems, MD, PhD,1 and his staff is greatly appreciated.
References (30)
- et al.
Comparison of clinical variables and variables derived from a limited predischarge exercise test as predictors of early and late mortality after myocardial infarction
J Am Coll Cardiol
(1985) - et al.
Which exercise test variables are of prognostic importance post-myocardial infarction?
Int J Cardiol
(1988) - et al.
Prediction of atherosclerotic cardiovascular death in men using a prognostic score
Am J Cardiol
(1994) - et al.
Comparitive value of maximal treadmill testing, exercise thallium myocardial perfusion scintigraphy and exercise radionuclide ventriclography for distinguishing high- and low-risk patients soon after acute myocardial infarction
Am J Cardiol
(1984) - et al.
Prediction of mortality during the first year after acute myocardial infarction from clinical variables and stress test at hospital discharge
Am J Cardiol
(1985) - et al.
Prediction of functional capacity and use of exercise testing for predicting risk after acute myocardial infarction
Am J Cardiol
(1985) - et al.
Risk stratification by early exercise testing after an episode of unstable coronary artery disease
Int J Cardiol
(1993) - et al.
Comparison of Clinical and treadmill variables for the prediction of outcome after myocardial infarction
J Am Coll Card
(1984) - et al.
Prognostic significance of peak exercise capacity in patients with coronary artery disease
J Am Coll Cardiol
(1994) - et al.
Prognostic value of training-induced change in peak exercise capacity in patients with myocardial infarcts and patients with coronary bypass surgery
Am J Cardiol
(1995)
The prognostic value of exercise capacity: a review of the literature
Am Heart J
Noninvasive predictors of sudden cardiac death in men with coronary heart disease. Predictive value of maximal stress testing
Am J Cardiol
Prognostic importance of a clinical profile and exercise test in medically treated patients with coronary artery disease
J Am Coll Cardiol
The role of exercise testing in identifying patients with improved survival after coronary bypass
J Am Coll Cardiol
Prognosis in patients with a strongly positive exercise electrocardiogram
Am J Cardiol
Cited by (4)
How to assess physical activity? How to assess physical fitness?
2005, European Journal of Preventive CardiologyInfluence of the practice physical activity in the coronary artery bypass graft surgery results
2007, Brazilian Journal of Cardiovascular SurgeryPrognostic value of exercise tests performed 3 months after coronary artery grafting in evaluation cardiac events. 6 years follow-up
2002, Polskie Archiwum Medycyny Wewnetrznej