Angina pectoris and ST-segment depression during exercise testing early following acute myocardial infarction.

This study evaluates the prognostic value of ST-segment depression and angina pectoris occurring alone or in combination during exercise testing performed 3 weeks after myocardial infarction in 281 of 570 consecutive survivors of acute myocardial infarction. Neither angina pectoris (36 patients) nor ST-segment depression of at least 1 mm (46 patients) correlated with the occurrence of acute coronary events (cardiac death, myocardial infarction, unstable angina pectoris requiring hospitalization) during the subsequent year. Even a small group of patients (n = 13) with both angina and ST-segment depression did not suffer a higher occurrence of acute events. However, the presence of angina and/or ST-segment depression was strongly correlated with the subsequent performance of coronary arteriography. This study indicates that acute coronary events cannot be predicted by clinical or ECG evidence of myocardial ischemia during exercise tests performed 3 weeks after acute myocardial infarction.