EXERCISE TESTING 3 WEEKS AFTER MYOCARDIAL-INFARCTION

The purpose of this study was to evaluate the safety and utility of treadmill exercise testing prior to the discharge of patients admitted with acute myocardial infarction. Sixty-two of 109 consecutive patients were exercised without complications to 60 percent of their maximal heart rate at a mean of 18 days after admission. Exercise testing influenced management in 13 (21 percent) of the 62 patients; therapy with antiarrhythmic drugs was started in four patients, dosages of antianginal agents were increased in three patients, and hospitalization was prolonged in four patients. Fourteen patients died after discharge; six had undergone exercise testing. Follow-up information was obtained for a mean of 21 months in all 109 patients. Six (30 percent) of the 20 patients who developed ST-segment depression during during exercise either died or had another myocardial infarction after discharge from the hospital. This is in contrast to an occurrence of death or reinfarction in only two (5 percent) of the 42 patients who did not have ST-segment depression during exercise. These data suggest that the exercise test is safe and useful in management and may be valuable in predicting coronary events after hospitalization following myocardial infarction.