Different clinical and prognostic significance of painful and silent myocardial ischemia detected by exercise electrocardiography and dobutamine stress echocardiography after uncomplicated myocardial infarction.

Prevalence and prognostic significance of painful and silent ischemia detected by exercise electrocardiography (ECG) and dobutamine stress echocardiography (DSE) were evaluated in 407 consecutive patients recovering from acute myocardial infarction. Painful ischemia assessed by both tests was not associated with different clinical characteristics of patients; on the other hand, it identified a higher risk subgroup compared with silent ischemia during exercise ECG but not during DSE.