Skip to main content
SpringerLink
Log in

Risk Stratification

Exercise Testing, Imaging, and Cardiac Catheterization

  • Chapter
Management of Acute Coronary Syndromes

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 142 Accesses

Abstract

Each year, approx 1.1 million patients in the United States suffer an acute myocardial infarction (AMI) and 440,000 die (1). The number of index vs recurrent MI events is 650,000 and 450,000, respectively. Reperfusion therapy, increased use of adjunctive medication such as aspirin, β-blockers, angiotensin-converting enzyme inhibitors, and lipid lowering therapy coupled with better risk stratification to identify those most likely to benefit from early coronary revascularization has led to significant improved longterm prognosis after MI.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 169.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. American Heart Association. 2001 heart and stroke facts. American Heart Association, 2001.

    Google Scholar 

  2. Morrow DA, Antman EM, Charlesworth A, et al. TIMI risk score for ST-elevation myocardial infarction: a convenient, bedside, clinical score for risk assessment at presentation. An Intravenous nPA for Treatment of Infarcting Myocardium Early II Trial Substudy. Circulation 2000; 102: 2031–2037.

    Article  PubMed  CAS  Google Scholar 

  3. Morrow DA, Antman EM, Parsons L, et al. Application of the TIMI risk score for ST-elevation MI in the National Registry of Myocardial Infarction 3. JAMA 2001; 286: 1356–1359.

    Article  PubMed  CAS  Google Scholar 

  4. Cannon CP, Thompson B, McCabe CH, et al. Predictors of non-Q-wave acute myocardial infarction in patients with acute ischemic syndromes: an analysis from the Thrombolysis in Myocardial Ischemia (TIMI) III investigators. Am J Cardiol 1995; 75: 977–981.

    Article  PubMed  CAS  Google Scholar 

  5. Gurwitz JH, Gore JM, Goldberg RJ, Rubison M, Chandra N, Rogers WJ. Recent age-related trends in the use of thrombolytic therapy in patients who have had acute MI. National Registry of Myocardial Infarction. Ann Intern Med 1996; 124: 283–291.

    PubMed  CAS  Google Scholar 

  6. Hillis LD, Forman S, Braunwald E, and the Thrombolysis in Myocardial Infarction (TIMI) Phase II Co-investigators. Risk stratification before thrombolytic therapy in patients with acute myocardial infarction. J Am Coll Cardiol 1990; 16: 313–315.

    Article  PubMed  CAS  Google Scholar 

  7. Normand ST, Glickman ME, Sharma RG, McNeil BJ. Using admission characteristics to predict short-term mortality from myocardial infarction in elderly patients. Results from the Cooperative Cardiovascular Project. JAMA 1996; 275: 1822–1828.

    Article  Google Scholar 

  8. Rouleau JL, Talajic M, Sussex B, et al. Myocardial infarction patients in the 1990s-their risk factors, stratification and survival in Canada: The Canadian Assessment of Myocardial Infarction (CAMI) Study. J Am Coll Cardiol 1996; 27: 1119–1127.

    Article  PubMed  CAS  Google Scholar 

  9. Lee KL, Woodlieg LM, Topol EJ, Weaner D, Bertrin J, Califf RM. Predictors of 30 day mortality in the era of reperfusion for acute myocardial infarction. Results from international trial of 41,021 patients. Circulation 1995; 91: 1659–1663.

    Article  PubMed  CAS  Google Scholar 

  10. Aguirre FV, McMahon RP, Mueller H, et al. Impact of age on clinical outcome and postlytic management strategies in patients treated with intravenous thrombolytic therapy. Results from the TIMI II study. Circulation 1994; 90: 78–86.

    Article  PubMed  CAS  Google Scholar 

  11. Fibrinolytic Therapy Trialists’ (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1000 patients. Lancet 1994; 343: 311–322.

    Google Scholar 

  12. Vaccarino V, Krumholz HM, Berkman LF, Horwitz RI. Sex differences in mortality after myocardial infarction. Is there evidence for an increased risk for women? Circulation 1995; 91: 1861–1871.

    Article  PubMed  CAS  Google Scholar 

  13. Weaver WD, White HD, Wilcox RG, et al. Comparisons of characteristics and outcomes among women and men with acute myocardial infarction treated with thrombolytic therapy. GUSTO-1 Investigators. JAMA 1996; 275: 777–782.

    Article  PubMed  CAS  Google Scholar 

  14. Kober L, Torp-Pedersen C, Ottesen M, et al. Influence of gender on short-and long-term mortality after acute myocardial infarction. Am J Cardiol 1996; 77: 1052–1056.

    Article  PubMed  CAS  Google Scholar 

  15. Stone PH, Muller JE, Hartwell T, et al. The effect of diabetes mellitus on prognosis and serial left ventricular function after acute myocardial infarction: contribution of both coronary disease and left ventricular dysfunction to the adverse prognosis. The MILIS Study Group. JAm Coll Cardiol 1989; 14: 49–57.

    Article  CAS  Google Scholar 

  16. Granger CB, Calif RM, Young S, et al. Outcome of patients with diabetes mellitus and acute myocardial infarction treated with thrombolytic agents. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group. J Am Coll Cardiol 1993; 21: 920–925.

    Article  PubMed  CAS  Google Scholar 

  17. Aronson D, Rayfield EJ, Chesebro JH. Mechanisms determining course and outcome of diabetic patients who have had acute myocardial infarction. Ann Intern Med 1997; 126: 296–306.

    PubMed  CAS  Google Scholar 

  18. Abbot RD, Donaue R, Kannel WB. The impact of diabetes on survival following myocardial infarction in men vs. women: the Framingham Study. JAMA 1988; 260: 3456–3460.

    Article  Google Scholar 

  19. Abbud ZA, Shindler DM, Wilson AC, Kostis JB. Effect of diabetes mellitus on short-and long-term mortality rates of patients with acute myocardial infarction: a statewide study. Myocardial Infarction Data Acquisition System Study Group. Am Heart J 1995; 130: 51–58.

    Article  PubMed  CAS  Google Scholar 

  20. Capes SE, Hunt D, Malmberg K, Gerstein HC. Stress hyperglycemia and increased risk of death after myocardial infarction in patients with and without diabetes: a systematic overview. Lancet 2000; 355: 773–778.

    Article  PubMed  CAS  Google Scholar 

  21. Taylor HA, Chaitman BR, Rogers WJ, et al. TIMI Investigators. Race and prognosis after myocardial infarction. Results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial. Circulation 1993; 88: 1484–1494.

    Article  PubMed  CAS  Google Scholar 

  22. Keil JE, Sutherland SE, Knapp RG, Lackland DT, Gazes PC, Tyroler HA. Mortality rates and risk factors for coronary disease in black as compared with white men and women. N Engl J Med 1993; 329: 73–78.

    Article  PubMed  CAS  Google Scholar 

  23. Califf RM, Pieper KS, Lee KL, et al. Prediction of 1-year survival after thrombolysis for acute myocardial infarction in the Global Utilization of Streptokinase and TPA for Occluded Coronary Arteries Trial. Circulation 2000; 101: 2231–2238.

    Article  PubMed  CAS  Google Scholar 

  24. Killiip T III, Kimball JT. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients. Am J Cardiol 1967; 20: 456–464.

    Article  Google Scholar 

  25. Forrester JS, Diamond G, Chatterjee K, Swan HJ. Medical therapy of acute myocardial infarction by application of hemodynamic subsets. N Engl J Med 1976; 295: 1356–1362.

    Article  PubMed  CAS  Google Scholar 

  26. Multicentre Postinfarction Research Group. Risk stratification and survival after myocardial infarction. N Engl. J Med 1983; 309: 331–336.

    Google Scholar 

  27. Volpi A, DeVita C, Franzosi MG, et al. Determinants of the 6-month mortality in survivors of myocardial infarction after thrombolysis: results of the GISSI-2 database. Circulation 1993; 88: 416–429.

    Article  PubMed  CAS  Google Scholar 

  28. Warnowicz MA, Parker H, Chetlin MD. Prognosis of patients with acute pulmonary edema and normal ejection fraction after acute myocardial infarction. Circulation 1983; 67: 330–334.

    Article  PubMed  CAS  Google Scholar 

  29. Califf RM, Bengtson JR. Cardiogenic shock. N Engl J Med 1994; 330: 1724

    Article  PubMed  CAS  Google Scholar 

  30. O’Gara PT. Primary pump failure. In: Fuster V, Ross R, Topol E, eds. Atherosclerosis and Coronary Artery Disease. Raven Press, New York, 1995, p. 1051.

    Google Scholar 

  31. Bates ER, Topol EJ. Limitations of thrombolytic therapy for acute myocardial infarction complicated by congestive heart failure and cardiogenic shock. J Am Coll Cardiol 1991; 18: 1077.

    Article  PubMed  CAS  Google Scholar 

  32. Holmes DR, Bates ER, Kleiman NS, et al. Contemporary reperfusion therapy for cardiogenic shock: the GUSTO-1 trial experience. J Am Coll Cardiol 1995; 26: 668.

    Article  PubMed  Google Scholar 

  33. Hochman JS, Sleeper LA, Webb JG, et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Eng J Med 1999; 341: 625–634.

    Article  CAS  Google Scholar 

  34. Tomoda H, Aoki N. Prognostic value of C-reactive protein levels within six hours after the onset of acute myocardial infarction. Am Heart J 2000; 140: 324–328.

    Article  PubMed  CAS  Google Scholar 

  35. Ohman EM, Armstrong PW, Christenson RH, et al. Cardiac Troponin T levels for risk stratification in acute myocardial ischemia. N Engl J Med 1996; 335: 1333–1341.

    Article  PubMed  CAS  Google Scholar 

  36. Giannitsis E, Muller-Bardorff M, Lehrke S, et al. Admission Troponin T levels predict clinical outcome, TIMI flow, and myocardial tissue perfusion after primary percutaneous intervention for acute ST-segment elevation myocardial infarction. Circulation 2001; 104: 630–635.

    Article  PubMed  CAS  Google Scholar 

  37. Giannitsis E, Lehrke S, Weigand UK, et al. Risk stratification in patients with inferior acute myocardial infarction treated by percutaneous coronary interventions: the role of admission troponin T. Circulation 2000; 102: 2038–2044.

    Article  PubMed  CAS  Google Scholar 

  38. Ramanathan K, Stewart JT, Theroux P, French JK, White HD. Admission troponin T level may predict 90 minute TIMI flow after thrombolysis. Circulation 1997; 96 (Suppl. I): I - 270.

    Google Scholar 

  39. Matetzky S, Sharir T, Domingo M, et al. Elevated Troponin I level on admission is associated with adverse outcome of primary angioplasty in acute myocardial infarction. Circulation 2000; 102: 1611–1616.

    Article  PubMed  CAS  Google Scholar 

  40. Birnbaum Y, Herz I, Sclarovsky S, et al. Prognostic significance of the admission electrocardiogram in acute myocardial infarction. J Am Coll Cardiol 1996; 27: 1128–1132.

    Article  PubMed  CAS  Google Scholar 

  41. Bates ER, Clemmensen PM, Califf RM, et al. Precordial ST segment depression predicts a worse prognosis in inferior infarction despite reperfusion therapy. The Thrombolysis and Angioplasty in Myocardial Infarction (TAMI) Study Group. J Am Coll Cardiol 1990; 16: 1538–1544.

    Article  PubMed  CAS  Google Scholar 

  42. Wong CK, Freedman SB, Bautovich G, Bailey BP, Bernstein L, Kelly DT. Mechanisms and significance of precordial ST-segment depression during inferior wall acute myocardial infarction associated with severe narrowing of the dominant right coronary artery. Am J Cardiol 1993; 71: 1025.

    Article  PubMed  CAS  Google Scholar 

  43. Peterson ED, Hathaway WR, Zabel KM, et al. Prognostic significance of precordial ST segment depression during inferior myocardial infarction in the thrombolytic era: results in 16,521 patients. J Am Coll Cardiol 1996; 28: 305–312.

    Article  PubMed  CAS  Google Scholar 

  44. Birnbaum Y, Herz I, Sclaraovsky S, Ziotikamien B, Chetrit A, Barbash G. Prognostic significance of different patterns of precordial ST segment depression in inferior wall acute myocardial infarction. J Am Coll Cardiol 1995; 343A.

    Google Scholar 

  45. Zehender M, Kasper M, Kauder E, et al. Right ventricular infaction as an independent predictor of prognosis after acute inferior myocardial infarction. N Engl J Med 1993; 218: 981–988.

    Article  Google Scholar 

  46. Newby KH, Natale A, Krucoff MW, et al. The incidence and clinical relevance of bundle branch block in patients with acute myocardial infarction treated with thrombolytic agents. J Am Coll Cardiol 1995; 343A.

    Google Scholar 

  47. Shecter M, Rabinowitz B, Beker B, Motro M, Barbash G, Kaplinski E. Additional ST segment elevation during the first hour of thrombolytic therapy, an electrocardiographic sign predicting a favorable clinical outcome. J Am Coll Cardiol 1992; 20: 1460–1464.

    Article  Google Scholar 

  48. Mauri F, Maggioni AP, Franzosi MG, et al. A simple electrocardiographic predictor of the outcome of patients with acute myocardial infarction treated with a thrombolytic agent. A Gruppo Italiano per lo Studio della Sopravvienza nell’Infarto Miocardico (GISSI-2)-Derived Analysis. J Am Coll Cardiol 1994; 24: 600–607.

    Article  PubMed  CAS  Google Scholar 

  49. Schroder R, Wegscheider K, Schroder K, Dissmann R, Meyer-Sabellek W, for the INJECT Trial Group. Extent of early ST segment elevation resolution: a strong predictor of outcome in patients with acute myocardial infarction and a sensitive measure to compare thrombolytic regimens. A substudy of the International Joint Efficacy Comparison of Thrombolytics (INJECT) Trial. J Am Coll Cardiol 1995; 26: 1657–1664.

    Article  PubMed  CAS  Google Scholar 

  50. Silver MT, Rose GA, Paul SD, O’Donnell CJ, O’Gara PT, Eagle KA. A clinical rule to predict preserved left ventricular ejection fraction in patients after myocardial infarction. Ann Intern Med 1994; 121: 750–756.

    PubMed  CAS  Google Scholar 

  51. Shaw LJ, Peiper K, Peterson ED, Eagle KA, Wagner GS, Califf RM. Optimization of resources by efficient use of readily available simple clinical measures in a high-risk post-myocardial infarction population. Presented at the 13th Annual Meeting of the Association for Health Service Research, Atlanta, GA, June 9–11, 1996.

    Google Scholar 

  52. Andrews J, French JK, Manda SO, White HD. New Q waves on the presenting electrocardiogram independently predicts increased cardiac mortality following a first ST-elevation myocardial infarction. Eur Heart J 2000; 21: 647–653.

    Article  PubMed  CAS  Google Scholar 

  53. Brodie BR, Weintraub RA, Stuckey TD, et al. Outcomes of direct coronary angioplasty for acute myocardial infarction in candidates and non-candidates for thrombolytic therapy. Am J Cardiol 1991; 67: 7–12.

    Article  PubMed  CAS  Google Scholar 

  54. Himbert D, Juliard JM, Steg PG, et al. Primary coronary angioplasty for acute myocardial infarction with contraindication to thrombolysis. Am J Cardiol 1993; 71: 377–381.

    Article  PubMed  CAS  Google Scholar 

  55. Michels KB, Yusuf S. Does PTCA in acute myocardial infarction affect mortality and reinfarction rates? A quantitative overview (meta-analysis) of the randomized clinical trials. Circulation 1995; 91: 476–485.

    Article  PubMed  CAS  Google Scholar 

  56. Ellis SG, Ribeiro da Silva E, Heyndrickx GR, et al. Randomized comparison of rescue angioplasty with conservative management of patients with early failure of thrombolysis for acute anterior myocardial infarction. Circulation 1996; 90: 2280–2284.

    Article  Google Scholar 

  57. Ryan TJ, Antman EM, Brooks NH, et al. 1999 Update: ACC/AHA guidelines for the management of patients with acute myocardial infarction: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Acute Myocardial Infarction). J Am Coll Cardiol 1999; 34: 890–911.

    Article  Google Scholar 

  58. Reeder GS. Identification and management of the low-risk patient after myocardial infarction. ACC Curr J Rev 1997;May/June:27–31.

    Google Scholar 

  59. Peterson ED, Shaw LJ, Califf RM. Risk stratification after myocardial infarction. Ann Intern Med 1997; 126: 561–582.

    PubMed  CAS  Google Scholar 

  60. Mark DB, Sigmon K, Topol EJ, et al. Identification of acute myocardial infarction patients suitable for early hospital discharge after aggressive intervention therapy: results from the Thrombolysis and Angioplasty in Acute Myocardial Infarction Registry. Circulation 1991; 83: 1186–1193.

    Article  PubMed  CAS  Google Scholar 

  61. Villela A, Maggioni AP, Villela M, et al. Prognostic significance of maximal exercise testing after myocardial infarction treated with thrombolytic agents: the GISSI-2 database. Lancet 1995; 346: 523–529.

    Article  Google Scholar 

  62. Newby KL, Califf RM, Guerci A, et al. Early discharge in the thrombolytic era: an analysis of criteria for uncomplicated infarction from the GUSTO trial. J Am Coll Cardiol 1996; 27: 625–632.

    Article  PubMed  CAS  Google Scholar 

  63. Mueller HS, Forman SA, Menegns MA, Cohen LS, Knatterud GL, Braunwald E. Prognostic significance of nonfatal reinfarction during 3 year follow-up: results of the TIMI phase II trial. J Am Coll Cardiol 1995; 26: 900–907.

    Article  PubMed  CAS  Google Scholar 

  64. Barbagelata A, Granger CB, Topol EJ, et al. Frequency, significance and cost of recurrent ischemia after thrombolytic therapy for myocardial infarction. Am J Cardiol 1995; 76: 1007–1013.

    Article  PubMed  CAS  Google Scholar 

  65. Figuerdo V, Cheitlin MD. Risk stratification. In: Julain DG, Braunwald E, eds. Management of Acute Myocardial Infarction. W.B. Saunders, London, 1994, pp. 361–391.

    Google Scholar 

  66. Theroux P, Juneau M. Exercise and pharmacologic testing after acute myocardial infarction. In: Francis GS, Alpert JS, eds. Coronary Care. Little, Brown, Boston, 1993, pp. 615–628.

    Google Scholar 

  67. DeBusk RE Specialized testing after recent acute myocardial infarction. Ann Intern Med 1989; 110: 470.

    PubMed  CAS  Google Scholar 

  68. Topol EJ, Bates ER, Walton JA Jr, et al. Coronary angiography after thrombolytic therapy for acute myocardial infarction. Ann Intern Med 1991; 114: 877–885.

    PubMed  CAS  Google Scholar 

  69. The TIMI Study Group. Comparison of invasive and conservative strategies after treatment with intravenous tissue plasminogen activator in acute myocardial infarction: results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II Trial. N Engl J Med 1989; 329: 618–627.

    Google Scholar 

  70. Williams DO, Braunwald E, Knatterud G, TIMI Investigators. One-year results of the Thrombolysis in Myocardial Infarction Investigation (TIMI) Phase II Trial. Circulation 1992; 85: 533–542.

    Article  PubMed  CAS  Google Scholar 

  71. SWIFT (Should We Intervene Following Thrombolysis?) Trial Study Group. SWIFT trial of delayed elective intervention versus conservative treatment after thrombolysis with anistreplase in acute myocardial infarction. BMJ 1991;302:555–560.

    Google Scholar 

  72. Gibson RS, Bishop HL, Stamm RB, Crampton RS, Beller GA, Martin RP. Value of early two-dimensional echocardiography in patients with acute myocardial infarction. Am J Cardiol 1982; 49: 1110–1119.

    Article  PubMed  CAS  Google Scholar 

  73. Horowitz RS, Morganroth J, Parrotto C, Chun CC, Soffer J, Pauletto FJ. Immediate diagnosis of acute myocardial infarction by two-dimensional echocardiography. Circulation 1982; 65: 323–329.

    Article  PubMed  CAS  Google Scholar 

  74. Nishimura RA, Tajek AJ, Shub C, Miller FA, Ilstrip DM, Harrison CE. Role of two-dimensional echocardiography in the prediction of inhospital complications after acute myocardial infarction. J Am Coll Cardiol 1984; 4: 1080–1087.

    Article  PubMed  CAS  Google Scholar 

  75. Jaarsma W, Visser CA, Eemgevan MJ, Verhengt FW, Kupper AJ. Predictive value of two-dimensional echocardiography and hemodynamic measurements on admission with acute myocardial infarction. J Am Soc Echocardiogr 1988; 1: 187–193.

    PubMed  CAS  Google Scholar 

  76. Saabia P, Abbott RD, Afrookteh A, Keller MW, Touchstone DA, Karl S. Importance of two dimensional echocardiographic assessment of left ventricular function in patients presenting to emergency room with cardiac related symptoms. Circulation 1991; 84: 1615–1624.

    Article  Google Scholar 

  77. White HD, Norris RM, Brown MA, Brandt PW, Whitlock RIVI, Wild CJ. Left ventricular end-systolic volume as the major determinant of survival after recovery from myocardial infarction. Circulation 1987; 76: 44.

    Article  PubMed  CAS  Google Scholar 

  78. Reeder GS, Gibbons RJ. Acute myocardial infarction: risk stratification in the thrombolytic era. Mayo Clin Proc 1995; 70: 87–94.

    PubMed  CAS  Google Scholar 

  79. Pilote L, Silberberg J, Lisbona R, Sniderman A. Prognosis in patients with low left ventricular ejection fraction after myocardial infarction. Circulation 1989; 80: 1636.

    Article  PubMed  CAS  Google Scholar 

  80. Cerisano G, Bolognese L, Carrabba N, et al. Doppler-derived mitral deceleration time: an early strong predictor of left ventricular remodeling after reperfused anterior acute myocardial infarction. Circulation 1999; 99: 230–236.

    Article  PubMed  CAS  Google Scholar 

  81. Nijland F, Kamp O, Karreman AJ, Van Eenige MJ, Visser CA. Prognostic implications of restrictive left ventricular filling in acute myocardial infarction: a serial doppler echocardiographic study. J Am Coll Cardiol 1997; 30: 1618–1624.

    Article  PubMed  CAS  Google Scholar 

  82. Sakate Y, Yoshiyama M, Hirata K, et al. Relationship between Doppler-derived left ventricular diastolic function and exercise capacity in patients with myocardial infarction. Jpn Circ J 2001; 65: 627–631.

    Article  PubMed  CAS  Google Scholar 

  83. Miyashita T, Okano Y, Takaki H, Satoh T, Kobayashi Y, Goto Y. Relation between exercise capacity and left ventricular systolic versus diastolic function during exercise in patients after myocardial infarction. Coron Artery Dis 2001; 12: 217–225.

    Article  PubMed  CAS  Google Scholar 

  84. Chaitman BR, McMahon RP, Terrin M, et al. Impact of treatment strategy on predischarge exercise test in the Thrombolysis in Myocardial Infarction (TIMI) II trial. Am J Cardiol 1993; 71: 131–138.

    Article  PubMed  CAS  Google Scholar 

  85. Dominguez H, Torp-Prdersen C, Koeber L, Rask-Madsen C. Prognostic value of exercise testing in a cohort of patients followed for 15 years after acute myocardial infarction. Eur Heart J 2001; 22: 300–306.

    Article  PubMed  CAS  Google Scholar 

  86. Dorn J, Naughton J, Imamura D, Trevisan M. Prognostic value of peak exercise systolic blood pressure on long-term survival after myocardial infarction. Am J Cardiol 2001; 87: 213.

    Article  PubMed  CAS  Google Scholar 

  87. Villella A, Maggioni AP, Villella M, et al. Prognostic significance of maximal exercise testing after myocardial infarction treated with thrombolytic agents: the GISSI-2 database. Lancet 1995; 346: 523–529.

    Article  PubMed  CAS  Google Scholar 

  88. Piccalo G, Pirelli S, Massa D, Cipriani M, Sarullo FM, De Vita C. Value of negative predischarge exercise testing in identifying patients at low risk after acute myocardial infarction treated by systemic thrombolysis. Am J Cardiol 1992; 70: 31–33.

    Article  PubMed  CAS  Google Scholar 

  89. Stevenson R, Umachandran V, Ranjandayalan K, Wilkinson P, Marchant B, Timms AD. Reassessment of treadmill stress testing for risk stratification in patients with acute myocardial infarction treated with thrombolysis. Br Heart J 1993; 70: 415–420.

    Article  PubMed  CAS  Google Scholar 

  90. Arnold AE, Simoons ML, Detry JM, et al. Prediction of mortality following hospital discharge after thrombolysis for acute myocardial infarction: is there a need for coronary angiography? The European Cooperative Study Group. Eur Heart J 1993; 14: 306–315.

    Article  PubMed  CAS  Google Scholar 

  91. Toft E. Neilson G, Mortenson B, Dalsgaard D, Mansen JB, Rasmussen K. The prognostic value of exercise testing early after myocardial infarction in patients treated with thrombolytics. Eur Heart J 1995; 16: 1177–1180.

    PubMed  CAS  Google Scholar 

  92. Khattar RS, Basu SK, Ranal V, Senior R, Lahiri A. Prognostic value of predischarge exercise testing, ejection fraction and ventricular ectopic activity in acute myocardial infarction treated with streptokinase. Am J Cardiol 1996; 78: 136–141.

    Article  PubMed  CAS  Google Scholar 

  93. Juneau M, Colles P, Theroux P, et al. Symptom-limited versus low level exercise testing before hospital discharge after myocardial infarction. J Am Coll Cardiol 1992; 20: 927–933.

    Article  PubMed  CAS  Google Scholar 

  94. Jain A, Myers GH, Sapin PM, O’Rourke RA. Comparison of symptom-limited and low level exercise tolerance tests early after myocardial infarction. J Am Coll Cardiol 1993; 22: 1816–1820.

    Article  PubMed  CAS  Google Scholar 

  95. Shaw LJ, Peterson ED, Kesler K, Hasselblad V, Califf RM. A metaanalysis of predischarge risk stratification after acute myocardial infarction with stress electrocardiographic, myocardial perfusion and ventricular function imaging. Am J Cardiol 1996; 78: 1327–1337.

    Article  PubMed  CAS  Google Scholar 

  96. Ritchie JL, Gibbons RJ, Cheitlin MD, et al. ACC/AHA guidelines for exercise testing. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Exercise Testing). J Am Coll Cardiol 1997; 30: 260–315.

    Article  PubMed  Google Scholar 

  97. Bogaty P, Dumont S, O’Hara GE, et al. Randomized trial of noninvasive strategy to reduce hospital stay for patients with low-risk myocardial infarction. J Am Coll Cardiol 2001; 37: 1289–1296.

    Article  PubMed  CAS  Google Scholar 

  98. Miller TD, Gersh BJ, Christian TF, Bailey KR, Gibbons RJ. Limited prognostic value of thallium-201 exercise treadmill testing early after myocardial infarction in patients treated with thrombolysis. Am Heart J 1995; 130: 259–266.

    Article  PubMed  CAS  Google Scholar 

  99. Tilkemeier PL, Guiney TE, LaRaia PJ, Boucher CA. Prognostic value of predischarge low-level exercise thallium testing after thrombolytic treatment of acute myocardial infarction. Am J Cardiol 1990; 66: 1203–1207.

    Article  PubMed  CAS  Google Scholar 

  100. Hendel RC, Gore JM, Alpert JS, Leppo JA. Prognosis following interventional therapy for acute myocardial infarction utility of dipyridamole thallium scintigraphy. Cardiology 1991; 79: 73–80.

    Article  PubMed  CAS  Google Scholar 

  101. Bowling BA, Aljuni SC, Puchrowicz S, Juni JE, Grines CE. Assessing the utility of exercise nuclear scintigraphy after reperfusion following myocardial infarction. Circulation 1992; 86 (Suppl. I): I - 136.

    Google Scholar 

  102. Mahmarian JJ, Mahmarian AC, Marks GF, Pratt CM, Verani MS. Role of adenosine thallium-201 tomography for defining long-term risk in patients after acute myocardial infarction. J Am Coll Cardiol 1995; 25: 1333–1340.

    Article  PubMed  CAS  Google Scholar 

  103. Basu S, Senior R, Dore C, Lahiri A. Value of thallium 201 imaging in detecting adverse cardiac events after myocardial infarction and thrombolysis: a follow up of 100 consecutive patients. BMJ 1996; 313: 844–848.

    Article  PubMed  CAS  Google Scholar 

  104. Travin MI, Dessouki A, Cameron T, Heller GV. Use of exercise technetium-99m sestamibi SPECT imaging to detect residual ischemia and for risk stratification after acute myocardial infarction. Am J Cardiol 1985; 75: 665–669.

    Article  Google Scholar 

  105. Dakik MA, Mahmarian JK, Kimball KT, Koutelow MG, Medrano R, Verani MS. Prognostic value of exercise T1–201 tomography in patients treated with thrombolytic therapy during myocardial infarction. Circulation 1996; 94: 2735–2742.

    Article  PubMed  CAS  Google Scholar 

  106. Leppo JA, O’Brien J, Rothendler JA, Getchell JD, Lee VW. Dipyridamole thallium 201 scintigraphy in the prediction of future cardiac events after acute myocardial infarction. N Engl J Med 1984; 310: 1014–1018.

    Article  PubMed  CAS  Google Scholar 

  107. Brown KA, O’Meara J, Chambers CE, Plante DA. Ability of dipyridamole-thallium-201 imaging one to four days after acute myocardial infarction to predict inhospital and late recurrent ischemic events. Am J Cardiol 1990; 65: 160–167.

    Article  PubMed  CAS  Google Scholar 

  108. Miller TD, Christian TF, Hopfenspirger MR, Hodge DO, Gersh BJ, Gibbons RJ. Infarct size after acute myocardial infarction measured by quantitative tomographic 99mTc sestamibi imaging predicts subsequent mortality. Circulation 1995; 92: 334–341.

    Article  PubMed  CAS  Google Scholar 

  109. Ryan T, Armstrong WF, O’Donnell JA, Feigenbaum H. Risk stratification after acute myocardial infarction by means of exercise two-dimensional echocardiography. Am Heart J 1987; 114: 1305–1316.

    Article  PubMed  CAS  Google Scholar 

  110. Applegate RJ, Dell’Italia LJ, Crawford MH. Usefulness of two-dimensional echocardiography during low-level exercise testing early after uncomplicated acute myocardial infarction. Am J Cardiol 1987; 60: 10–14.

    Article  PubMed  CAS  Google Scholar 

  111. Quintana M, Lindvall K, Ryden L, Brolund E Prognostic value of predischarge exercise stress echocardiography after acute myocardial infarction. Am J Cardiol 1995; 76: 1115–1121.

    Article  PubMed  CAS  Google Scholar 

  112. Smart SC, Knickelbine T, Stoiber TR, Carlos M, Wynsen JC, Sagar KB. Safety and accuracy of dobutamine-atropine stress echocardiography for the detection of residual stenosis of the infarct-related artery and multivessel disease during the first week after acute myocardial infarction. Circulation 1997; 95: 1394–1401.

    Article  PubMed  CAS  Google Scholar 

  113. Carlos ME, Smart SC, Wynsen JC, Sagar KB. Dobutamine stress echocardiography for risk stratification after myocardial infarction. Circulation 1997; 95: 1402–1410.

    Article  PubMed  CAS  Google Scholar 

  114. Pierard LA, De Landsheere CM, Berthe C, Rigo P, Kulbertus HE. Identification of viable myocardium by echocardiography during dobutamine infusion in patients with myocardial infarction after thrombolytic therapy: comparison with positron emission tomography. J Am Coll Cardiol 1990; 15: 1021–1031.

    Article  PubMed  CAS  Google Scholar 

  115. Picano E, Sicari R, Landi P, et al. Prognostic value of myocardial viability in medically treated patients with global left ventricular dysfunction early after an acute uncomplicated myocardial infarction: a dobutamine stress echocardiographic study. Circulation 1998; 98: 1078–1084.

    Article  PubMed  CAS  Google Scholar 

  116. Iliceto S, Caiali C, Ricci A. Prediction of cardiac events after uncomplicated myocardial infarction by cross-sectional echocardiography during transesophageal atrial pacing. Int J Cardiol 1990; 28: 95–103.

    Article  PubMed  CAS  Google Scholar 

  117. Bolognese L, Rossi L, Sarasso G, et al. Silent versus symptomatic dipyridamole-induced ischemia after myocardial infarction: clinical and prognostic significance. J Am Coll Cardiol 1992; 19: 953–959.

    Article  PubMed  CAS  Google Scholar 

  118. Camerici, Picano E, Landi P. Prognostic value of dipyridamole echocardiography early after myocardial infarction in elderly patients. J Am Coll Cardiol 1993; 22: 1809–1815.

    Google Scholar 

  119. Picano E, Pingitore A, Sicari R, et al. Stress echocardiographic results predict risk reinfarction early after uncomplicated acute myocardial infarction: large-scale multicenter study. J Am Coll Cardiol 1995; 26: 908.

    Article  PubMed  CAS  Google Scholar 

  120. Greco CA, Salustri A, Seccareccia F, et al. Prognostic value of dobutamine echocardiography early after uncomplicated acute myocardial infarction: a comparison with exercise electrocardiography. J Am Coll Cardiol 1997; 29: 261–267.

    Article  PubMed  CAS  Google Scholar 

  121. Salustri A, Ciavatti M, Seccareccia F, Palamara A. Prediction of cardiac events after uncomplicated acute myocardial infarction by clinical variables and dobutamine stress test. J Am Coll Cardiol 1999; 34: 435–440.

    Article  PubMed  CAS  Google Scholar 

  122. Ritchie JL, Bateman TM, Bonow RO, et al. Guidelines for clinical use of cardiac radionuclide imaging: report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures (Committee on Radionuclide Imaging) developed in collaboration with the American Society of Nuclear Cardiology. J Am Coll Cardiol 1995; 25: 521–527.

    Article  PubMed  CAS  Google Scholar 

  123. Ellis SG, Mooney MR, George GS, et al. Randomized trial of late elective angioplasty versus conservative management for patients with residual stenoses after thrombolytic treatment of myocardial infarction. Circulation 1992; 86: 1400–1406.

    Article  PubMed  CAS  Google Scholar 

  124. Mark DB, Naylor CD, Hlatky MA, et al. Use of medical resources and quality of life after acute myocardial infarction in Canada and the United States. N Engl J Med 1994; 331: 1130–1135.

    Article  PubMed  CAS  Google Scholar 

  125. Rouleau JL, Moye LA, Pfeffer MA, Arnold JM, for the SAVE investigators. A comparison of management patterns after acute myocardial infarction in Canada and United States-the SAVE investigators. N Engl J Med 1993; 328: 779–784.

    Article  PubMed  CAS  Google Scholar 

  126. Rogers WJ, Bowlby LT, Chandra NC, et al. Treatment of myocardial infarction in the United States (1990–1993). Observations from National Registry of Myocardial Infarction. Circulation 1994; 90: 2103–2114.

    Article  PubMed  CAS  Google Scholar 

  127. Pfeffer MA, Braunwald E, Moye LA on behalf of the SAVE investigators. Effect of Captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. N Engl J Med 1992; 327: 669–667.

    Article  PubMed  CAS  Google Scholar 

  128. Maggioni AP, Zuanetti G, Franzosi MG, et al. Prevalence and prognostic significance of ventricular arrhythmia after acute myocardial infarction in the fibrinolytic era. GISSI-2 results. Circulation 1993; 87: 312–322.

    Article  PubMed  CAS  Google Scholar 

  129. Moss AJ, Davis HJ, DeCamilla J, Bayer LW. Ventricular ectopic beats and their relation to sudden and nonsudden cardiac deaths after myocardial infarction. Circulation 1979; 60: 998–1003.

    Article  PubMed  CAS  Google Scholar 

  130. Bigger JT, Fleiss JL, Kleiger R, Miller JP, Rolnitzky LM and the Multicenter Post-Infarction Research Group. The relationships among ventricular arrhythmias, left ventricular dysfunction and mortality in the 2 years after myocardial infarction. Circulation 1984; 69: 250–258.

    Google Scholar 

  131. Mukharji J, Rude RE, Poole WK. The MILIS study group. Risk factors for sudden death after acute myocardial infarction. Two year follow-up. Am J Cardiol 1984; 54: 31–36.

    Article  PubMed  CAS  Google Scholar 

  132. McClements BM, Adgey AAJ. Value of signal-averaged electrocardiography, radionuclide ventriculography, Holter monitoring and clinical variables for prediction of arrhythmic events in survivors of acute myocardial infarction in the thrombolytic era. J Am Coll Cardiol 1993; 21: 1419–1427.

    Article  PubMed  CAS  Google Scholar 

  133. Singh N, Mironov D, Armstrong PW, Ross AM, Langer A, for the GUSTO ECG Substudy Investigators. Heart rate variability assessment early after acute myocardial infarction. Pathophysiological and prognostic correlates. Circulation 1996; 93: 1388–1395.

    Article  PubMed  CAS  Google Scholar 

  134. Farrell TG, Bashir Y, Cripps T, et al. Risk stratification for arrhythmic events in postinfarction patients based on heart rate variability, ambulatory electrocardiographic variables and the signal-averaged electrocardiogram. J Am Coll Cardiol 1991; 18: 687–697.

    Article  PubMed  CAS  Google Scholar 

  135. Reinhardt L, Makijarvi M, Fetsch T, et al. Noninvasive risk modeling after myocardial infarction. Am J Cardiol 1996; 78: 627–632.

    Article  PubMed  CAS  Google Scholar 

  136. Fei L, Copie X, Malik M, Camm AJ. Short-and long-term assessment of heart rate variability for risk stratification after acute myocardial infarction. Am J Cardiol 1996; 77: 681–684.

    Article  PubMed  CAS  Google Scholar 

  137. Denes P, el-Sherif N, Katz R, et al. Prognostic significance of signal-averaged electrocardiogram after thrombolytic therapy and/or angioplasty during acute myocardial infarction (CAST substudy). Cardiac Arrhythmia Suppression Trial (CAST) SAECG Substudy Investigators. Am J Cardiol 1994; 74: 216–220.

    Article  PubMed  CAS  Google Scholar 

  138. Richards DA, Blyth K, Ross DL, Uther JB. What is the best predictor of spontaneous ventricular tachycardia and sudden death after myocardial infarction? Circulation 1991; 83: 756–763.

    Article  PubMed  CAS  Google Scholar 

  139. Zoni-Berisso M, Molini D, Mela GS, Vecchio C. Value of programmed ventricular stimulation in predicting sudden death and sustained ventricular tachycardia in survivors of acute myocardial infarction. Am J Cardiol 1996; 77: 673–680.

    Article  PubMed  CAS  Google Scholar 

  140. Pedretti R, Etro MD, Laporta A, Braga SS, Caru B. Prediction of late arrhythmic events after acute myocardial infarction from combined use of noninvasive prognostic variables and inducibility of sustained monomorphic ventricular tachycardia. Am J Cardiol 1993; 71: 1131–1141.

    Article  PubMed  CAS  Google Scholar 

  141. Moss AJ, Hall J, Cannom DS, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. N Engl J Med 1996; 335: 1933–1940.

    Article  PubMed  CAS  Google Scholar 

  142. Buxton AE, Lee KL, Fisher JD, et al. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med 1999; 341: 1882–1890.

    Article  PubMed  CAS  Google Scholar 

Download references

Authors
  1. Sanjeev Puri MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hani A. Razek MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bernard R. Chaitman MD, FACC
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Cardiovascular Division, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA

    Christopher P. Cannon MD (Associate Professor of Medicine) (Associate Professor of Medicine)

Rights and permissions

Reprints and permissions

Copyright information

© 2003 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Puri, S., Razek, H.A., Chaitman, B.R. (2003). Risk Stratification. In: Cannon, C.P. (eds) Management of Acute Coronary Syndromes. Contemporary Cardiology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-59259-351-4_15

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-351-4_15

  • Publisher Name: Humana Press, Totowa, NJ

  • Print ISBN: 978-1-58829-309-1

  • Online ISBN: 978-1-59259-351-4

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation