急性心肌梗死后早期运动试验中的心绞痛与ST段压低

摘要(中文译文)

本研究评估了急性心肌梗死存活者中，在心肌梗死后3周进行运动试验时单独出现或合并出现的ST段压低和心绞痛对预后的判断价值，研究对象为570例连续急性心肌梗死存活者中的281例。心绞痛（36例）和至少1 mm的ST段压低（46例）均与随后一年内急性冠状动脉事件（心源性死亡、心肌梗死、需住院的不稳定性心绞痛）的发生无关。即使是在同时具有心绞痛和ST段压低的少数患者组（n＝13）中，急性事件的发生率也并不更高。然而，心绞痛和/或ST段压低的出现与随后进行冠状动脉造影密切相关。本研究表明，在急性心肌梗死后3周进行的运动试验中，临床或心电图所提示的心肌缺血并不能预测急性冠状动脉事件。

Abstract

This study evaluates the prognostic value of ST-segment depression and angina pectoris occurring alone or in combination during exercise testing performed 3 weeks after myocardial infarction in 281 of 570 consecutive survivors of acute myocardial infarction. Neither angina pectoris (36 patients) nor ST-segment depression of at least 1 mm (46 patients) correlated with the occurrence of acute coronary events (cardiac death, myocardial infarction, unstable angina pectoris requiring hospitalization) during the subsequent year. Even a small group of patients (n = 13) with both angina and ST-segment depression did not suffer a higher occurrence of acute events. However, the presence of angina and/or ST-segment depression was strongly correlated with the subsequent performance of coronary arteriography. This study indicates that acute coronary events cannot be predicted by clinical or ECG evidence of myocardial ischemia during exercise tests performed 3 weeks after acute myocardial infarction.

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