Predischarge stress test after myocardial infarction in the old age: Results and prognostic value

The aim of this study was to evaluate the results of predischarge stress testing in the elderly, and to assess the prognostic value of the test during one-year follow-up. The database consisted of 48 patients older than 64 years of age and 109 patients 55-64 years of age, who survived acute myocardial infarction, out of 532 conse-cutive patients admitted for myocardial infarction. Stress-test results were not different in the two groups. During one-year follow-up mortality was 6 % in the younger patients and 4 % in the older group, and the incidence of non-fatal reinfarctions was 8 % in both groups. Mortality was best predicted by the extent of blood pressure rise (43±26mmMg in survivors vs 19 ±15 mmHg in non-survivors, P<0-001). Stress-test results were no more predictive when non-fatal reinfarction was added to mortality as an end-point. We con-clude that for patients in whom the stress test is not contraindicated, (1) age does not affect stress test results, (2) the extent of blood pressure rise during a stress test is the best single predictor of mortality, (3) stress tests are not predictive of reinfarctions