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Usefulness of 500-m walk electrocardiogram test on clinical outcomes in patients with ST-segment elevation myocardial infarction

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Abstract

The current Japanese guideline for ST-segment elevation myocardial infarction (STEMI) recommends 500-m walk electrocardiogram (ECG) test for patients with STEMI during hospitalization. However, little is known regarding the association between acute phase 500-m walk ECG test and clinical outcomes. The purpose of this study was to investigate the association between 500-m walk ECG test and mid-term clinical outcomes in patients with STEMI. A total of 313 STEMI patients who underwent primary percutaneous coronary interventions were included, and were divided into the successful 500-m group (n = 263) and the unsuccessful 500-m group (n = 50). The primary endpoint was the major adverse cardiovascular events (MACE), which were defined as the composite of all cause death, acute myocardial infarction, readmission for heart failure, and ischemia-driven target vessel revascularization (TVR). During the follow-up period (median 223 days), a total of 55 MACE were observed. The log-rank test revealed that MACE, all cause death, readmission for heart failure, and ischemia-driven TVR were more frequently observed in the unsuccessful 500-m group than the successful 500-m group. In the multivariate Cox proportional hazard model, the unsuccessful 500-m walk ECG test was significantly associated with MACE (OR 5.62, 95% CI 3.08–10.08, P < 0.01) after controlling confounding factors such as age, and serum creatinine levels. In conclusion, the unsuccessful 500-m walk ECG test was significantly associated with poor mid-term outcomes in patients with STEMI. Our results suggest the usefulness of 500-m walk ECG test to stratify the high-risk group from patients with STEMI.

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Acknowledgements

The authors acknowledge all staff in the catheter laboratory and cardiovascular wards in Saitama Medical Center, Jichi Medical University, for their technical support in this study.

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Authors and Affiliations

  1. Division of Cardiovascular Medicine, Saitama Medical Center, Jichi Medical University, 1-847 Omiya-ku, Amanuma, Saitama, 330-8503, Japan

    Jumpei Ohashi, Kenichi Sakakura, Wataru Sasaki, Yousuke Taniguchi, Kunihiro Kani, Kei Yamamoto, Takunori Tsukui, Masaru Seguchi, Hiroshi Wada, Shin-ichi Momomura & Hideo Fujita

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  1. Jumpei Ohashi
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  2. Kenichi Sakakura
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  3. Wataru Sasaki
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Correspondence to Kenichi Sakakura.

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Conflict of interest

Dr. Sakakura has received speaking honoraria from Abbott Vascular, Boston Scientific, Medtronic Cardiovascular, Terumo, OrbusNeich, Japan Lifeline, and NIPRO. He has served as a proctor for Rotablator for Boston Scientific and has served as a consultant for Abbott Vascular and Boston Scientific. Prof. Fujita served as a consultant for Mehergen Group Holdings, Inc.

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Ohashi, J., Sakakura, K., Sasaki, W. et al. Usefulness of 500-m walk electrocardiogram test on clinical outcomes in patients with ST-segment elevation myocardial infarction. Heart Vessels 36, 48–57 (2021). https://doi.org/10.1007/s00380-020-01667-0

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