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Incidence of acute myocardial infarction in patients with exercise-induced silent myocardial ischemia

Journal Article · · Am. J. Cardiol.; (United States)

Fifty-five patients with angiographically proved coronary artery disease (CAD) underwent Bruce protocol exercise stress testing with thallium-201 imaging. Twenty-seven patients (group I) showed myocardial hypoperfusion without angina pectoris during stress, which normalized at rest, and 28 patients (group II) had a similar pattern of reversible myocardial hypoperfusion but also had angina during stress. Patients were followed for at least 30 months. Six patients in group I had an acute myocardial infarction (AMI), 3 of whom died, and only 1 patient in group II had an AMI (p = 0.05), and did not die. Silent myocardial ischemia uncovered during exercise stress thallium testing may predispose to subsequent AMI. The presence of silent myocardial ischemia identified in this manner is of prognostic value, independent of angiographic variables such as extent of CAD and left ventricular ejection fraction.

Research Organization:
Medical Univ. of South Carolina, Charleston
OSTI ID:
6863052
Journal Information:
Am. J. Cardiol.; (United States), Journal Name: Am. J. Cardiol.; (United States) Vol. 6; ISSN AJCDA
Country of Publication:
United States
Language:
English