The prognostic value of maximal exercise testing soon after first myocardial infarction.

The prognostic value of ST-segment depression during maximal exercise test performed in the third to fourth week after acute myocardial infarction (AMI), was studied in 126 consecutive patients with no evidence of previous myocardial infarction, unstable angina pectoris or severe heart failure. All patients on average increased their pressure-rate product by 2.6 and no complications occurred. Within the first year of follow-up, major cardiac events occurred in 9 patients (20%), and were fatal in 6 (13%), of the 46 patients who developed ST-segment depression during exercise. Only 3 major cardiac events (4%) occurred in the 80 patients without exercise induced ST-segment depression. Depression of the ST-segment on maximal exercise was a significant predictor of subsequent cardiac events in these survivors of first AMI.