Risk Stratification with Low‐level Exercise Testing 2 Weeks After Acute Myocardial Infarction
Risk Stratification with Low‐level Exercise Testing 2 Weeks After Acute Myocardial Infarction
复制标题
急性心肌梗死后两周低水平运动测试的风险分层
作者：
F. M. Weld;K. Chu;J. Bigger;L. Rolnitzky
我们招募了250例从心脏重症监护病房出院的急性心肌梗死患者。在出院前进行低水平运动试验的236例患者中，52例（22%）的心电图导联V有至少0.1 mV的运动诱发ST段下降，102例（43%）有室性心律失常，121例（51%）的运动能力短于6分钟。我们使用多元逻辑回归分析来调查运动变量与1年内心脏死亡率的关系。无论是否控制其他运动变量的影响，运动时间和心室过早去极化（VPDs）与急性心肌梗死后1年死亡率均显著相关；运动引起的ST段抑制与1年心脏死亡率的关联无统计学意义。标准化回归系数显示，各变量的预测价值排序依次为：运动时间、VPD频率和ST抑郁。叠刀技术显示使用三个运动变量的多重逻辑回归在预测1年死亡率方面是高度准确的。
We enrolled 250 patients with acute myocardial infarction after they had been discharged from the cardiac intensive care unit. Among 236 patients who performed a low-level exercise test just before hospital discharge, 52 (22%) had exercise-induced ST depression of at least 0.1 mV in ECG lead V, 102 (43%) had ventricular arrhythmias, and 121 (51%) had an exercise capacity of shorter than 6 minutes. We used multiple logistic regression analysis to investigate the association of exercise variables with 1-year cardiac mortality. Exercise duration and ventricular premature depolarizations (VPDs) were significantly associated with 1-year mortality after acute myocardial infarction, both with and without control of the influence of other exercise variables statistically; the association of exercise-induced ST depression with l-year cardiac mortality was not statistically significant. Standardized regression coefficients showed that the variables ranked in the following order in terms of predictive value: exercise duration, VPD frequency and ST depression. Jackknife techniques showed that multiple logistic regression using the three exercise variables was highly accurate in predicting 1- year mortality.