Bardají Ruiz A
Sección de Cardiología, Hospital Universitario de Tarragona Joan XXIII.
Rev Esp Cardiol. 1998 Jul;51(7):541-6. doi: 10.1016/s0300-8932(98)74787-6.
Exercise testing is considered to play a major role in risk stratification after myocardial infarction. With the aim of improving prognosis, an exercise test should be able to identify patients at higher risk of coronary events. In this sense, its major limitation is a low positive predictive value, especially in patients who have been treated with thrombolytic agents. This fact limits its clinical value in the decision making process in individual patients. Finally, the decision to revascularize with angioplasty or surgery when only a positive exercise test result is taken into account, has not been proven to prolong life in these patients. All these considerations should make us think about some clinical attitudes that are taken for granted.
运动试验被认为在心肌梗死后的危险分层中起主要作用。为改善预后，运动试验应能够识别出发生冠状动脉事件风险较高的患者。从这个意义上讲，其主要局限性是阳性预测值较低，尤其是在接受过溶栓药物治疗的患者中。这一事实限制了其在个体患者决策过程中的临床价值。最后，仅考虑运动试验结果阳性时决定进行血管成形术或手术血运重建，尚未被证实在这些患者中能延长生命。所有这些考虑都应促使我们思考一些被视为理所当然的临床态度。
