PROSPECTIVE-STUDY POST - ACUTE MYOCARDIAL-INFARCTION

Long-term prognosis in acute myocardial infarction (AMI) can be related to a number of risk factors, including the electrocardiographic stress test (ECG Test). This study analizes its contribution to the prognosis and management of such patients. 60 individuals discharged from a coronary care unit, without or with persisting complications underwent an ECG test 4-6 weeks following AMI, and were followed for a period of 12-39 months. 40 cases had a negative ECG test. During follow-up they continued to be generally asymptomatic and their survival was 100%. Coronary angiography in patients younger than 45 years revealed mainly single vessel disease. 20 cases (33%) had a positive ECG test. During follow-up 50% of these had anginal manifestations, and coronary angiograms revealed mainly 2-3 vessel disease. 6 patients underwent surgical revascularization. One patient died awaiting surgery. Overall survival in this group was 95%. It is concluded that stress testing performed during the convalescence period of patients with an AMI allows recognition of patients with a potentially poorer prognosis, which can be modified by appropiate study and revascularization in selected cases, bringing survival expectations to the same level of more benign cases.