Mickley H, Madsen J K
Odense Universitetshospital, kardiologisk afdeling B.
Ugeskr Laeger. 2001 Jan 29;163(5):589-93.
In general, exercise testing in acute coronary syndrome (ACS) has been used in the assessment of physical capacity and to obtain prognostic information. Within recent years, however, a number of randomized studies have addressed the role of exercise testing in identifying patients, who may benefit from an invasive versus a conservative treatment strategy. According to the literature, a normal exercise test result after ACS is associated with an excellent clinical outcome. Patients who for clinical reasons are unable to perform an exercise test comprise a high risk group for future cardiac events. An invasive strategy is warranted in patients who continue to have angina and exhibit significant ST-segment depression in the exercise-ecg or reversible defects on perfusion scintigraphy. Based on the results of a recent, large scale randomized study, patients with unstable angina or acute non-Q-wave infarction appear to benefit from an early invasive treatment strategy--regardless of the results of a preceding exercise test.
一般而言，急性冠状动脉综合征（ACS）的运动试验已用于评估体能和获取预后信息。然而，近年来，一些随机研究探讨了运动试验在识别可能从侵入性治疗策略与保守治疗策略中获益的患者方面的作用。根据文献，ACS后运动试验结果正常与良好的临床结局相关。因临床原因无法进行运动试验的患者是未来心脏事件的高危人群。对于持续有胸痛且运动心电图显示明显ST段压低或灌注闪烁显像有可逆性缺损的患者，有必要采取侵入性策略。基于最近一项大规模随机研究的结果，不稳定型心绞痛或急性非Q波心肌梗死患者似乎从早期侵入性治疗策略中获益——无论先前运动试验的结果如何。
