Prognostic significance of ischemic episodes in patients with previous myocardial infarction.
Prognostic significance of ischemic episodes in patients with previous myocardial infarction.
复制标题
既往心肌梗塞患者缺血发作的预后意义。
DOI：
10.1016/0002-9149(88)91198-8
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发表时间：
1988
期刊：
影响因子：
--
通讯作者：
S. Stern
中科院分区：
文献类型：
--
作者：
D. Tzivoni;D. Tzivoni;A. Gavish;A. Gavish;D. Zin;D. Zin;S. Gottlieb;S. Gottlieb;M. Moriel;M. Moriel;A. Keren;A. Keren;S. Banai;S. Banai;S. Stern;S. Stern
This study assessed the prognostic significance of ischemic changes during daily activity as recorded by ambulatory electrocardiographic monitoring in a group of 224 low-risk postinfarction patients. Of the 224 patients studied, 74 (33%) had transient ischemic episodes on Holter monitoring. During the 28 months of follow-up the frequency of cardiac events (cardiac death, reinfarction, hospitalization for unstable angina, balloon angioplasty or coronary bypass surgery) was 51% among those with ischemic episodes on Holter monitoring, compared with 12% in those without such changes (p < 0.0001). The 74 patients with positive results in their exercise tests and Holter monitoring had a 51% event rate, compared with 20% among the 44 patients with a positive exercise test result but negative Holter results (p < 0.001). The event rate in those without ischemic changes either on the exercise test or on Holter was only 8.5%. Among patients with good (>40%) or reduced (<40%) left ventricular ejection fraction, those with transient ST depression on Holter had a significantly higher cardiac event rate compared with those without it. A similar event rate was found in patients with only silent, only symptomatic and with silent and symptomatic ischemic episodes.
