[Prognostic value of the exercise test performed less than 40 days after the first infarction].

Stress testing was performed in 159 men (mean age 49.83 years) between the 10th and 40th day after primary myocardial infarction. The average work achieved was 79 watts with a heart rate of 121/min, systolic blood pressure of 169 mmHg, and a double product of 20 544. The result was negative in 53 p. 100 of cases, and positive in 47 p. 100: the positive response was ischaemic in 23 p. 100 and non ischaemic in 24 p. 100 of cases. In the 2 years which followed, post-infarction angina was observed in 44 p. 100 of cases (14 p. 100 unstable angina), recurrent infarction in 7 p. 100 and death in 4 p. 100; coronary angiography was performed in 19 p. 100 of cases and coronary bypass surgery in 6 p. 100; 53 p. 100 of patients remained asymptomatic. The difference in predictive value between negative stress testing for an asymptomatic outcome and a positive ischaemic test for post-infarction angina and bypass surgery was important (p less than 0.001). The correlation was not as significant for death and recurrent infarction. The non-ischaemic positive result was of less value. There was no relationship to age but the prediction was more accurate in postero-inferior (p less than 0.001) than anterior infarction (p less than 0.05). The timing of the test affected the performance and patient comfort but had less influence on the results. Nevertheless, the predictive values were less good at 2 weeks than later on and significantly improved when testing was performed between the 10th and 11th week. However, early stress testing was valuable for identifying high risk subgroups.