[Ergometric test: prognostic significance in the pre-thrombolytic and thrombolytic period]

Abstract

In the pre-thrombolytic era exercise testing showed the ability to identify a low-risk population with a 1 year event rate < 1% and a moderate-high risk group with an event rate up to 17% within 1 year after acute myocardial infarction. The most significant parameters are the markers of compromised left ventricular contractility. Since the introduction of thrombolytic therapy the negative predictive ability of exercise testing has been questioned, due to the frequent occurrence of residual coronary stenosis with atherosclerotic plaque characterized by marked instability, to the point that the usefulness of exercise testing has been challenged. Nevertheless the available information, albeit sparse, seems to confirm that the negative predictive ability of exercise testing is still adequate (good), and certainly not inferior to that in pre-thrombolytic era.