Valls Serral A, Bodí Peris V, Sanchis Fores J, Insa Pérez L, Gómez-Aldaraví Gutiérrez R, Llácer Escorihuela A, López Merino V. [The prognostic factors after an acute myocardial infarct treated with fibrinolytics].
Rev Esp Cardiol 1999;
52:95-102. [PMID:
10073090 DOI:
10.1016/s0300-8932(99)74875-x]
[Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND
The usefulness of the exercise test in evaluating patients with an acute myocardial infarction treated with fibrinolytics is controversial. On the other hand, the prognostic value of a patent infarct-related artery has not been clearly established. The objectives of this study were to assess the validity of the exercise test and to study the prognostic value of the artery patency after a myocardial infarction.
MATERIAL AND METHODS
We studied 99 patients with a myocardial infarction treated with fibrinolytics, non-complicated. An exercise test and a cardiac catheterization were performed in the first month. The patients were followed-up for 2 years, recording the major cardiac events (death and reinfarction) and the minor events (angina class (II, left cardiac failure class (II or maintained ventricular tachycardia).
RESULTS
On multivariate analysis with Cox regression, a workload < 4 METS at the exercise test was the only independent prognostic factor of major events (RR 5.6; CI 95% 1.68-19). The independent prognostic factors of minor events were: multivessel disease (RR 3.36; CI 95% 1.56-7.24), anterior infarction (RR 3.15; CI 95% 1.3-7.6), abnormal exercise test (RR 2.98; CI 95% 1.46-6.09) and ejection fraction < or = 40% (RR 2.48; CI 95% 1.07-5.74). The patency of the infarct-related artery was not a predictor of events.
CONCLUSIONS
The exercise test is useful in predicting the prognosis in patients treated with fibrinolytics. An occluded infarct-related artery was not an independent predictor of cardiac events in 2 years of follow-up.
Collapse