PMID: 9420687Mar 1, 1994Paper

Assessing prognosis after acute myocardial infarction in the thrombolytic era

Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology
L W Gimple, G A Beller

Abstract

The use of physiologic testing for prognostication continues to be useful and widely applied in the predischarge evaluation of patients recovering from an uncomplicated acute myocardial infarction in the thrombolytic era. Because patients with abnormal exercise test results are now routinely sent for angiography, there are no randomized trials or experimental confirmation that exercise parameters are still associated with the same prognostic value in the thrombolytic era. Nevertheless, the excellent outcomes in patients treated with thrombolytic therapy and risk stratified with exercise testing provide strong empiric support for the continued use of noninvasive testing of patients without complications after thrombolytic therapy. Reviews of patient cohorts enrolled in trials of thrombolytic therapy show that these patients have a lower incidence of multivessel disease and less evidence of ischemia (ST segment depression or thallium 201 redistribution) compared with prethrombolytic cohorts. For this and other reasons, the sensitivity and specificity of exercise variables for prognosis or detection of multivessel disease are not as strong. The addition of perfusion imaging will enhance the sensitivity for detection of ischemia wi...Continue Reading

References

May 15, 1991·Annals of Internal Medicine·E J TopolW J Rogers
Mar 15, 1990·The New England Journal of Medicine·A J Moss, J Benhorin
Jun 1, 1988·Journal of the American College of Cardiology·S P SchulmanK L Baughman
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Aug 11, 1983·The New England Journal of Medicine·UNKNOWN Multicenter Postinfarction Research Group

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Citations

Mar 1, 1995·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·G A Beller
Nov 1, 1996·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·K A Brown
Dec 30, 1998·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·G A Beller, K A Brown

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