Circulation, Vol 65, 452-456, Copyright © 1982 by American Heart Association
GR Dagenais, JR Rouleau, A Christen and J Fabia
To assess the prognosis of patients with a strongly positive exercise ECG,
the 5-year cumulative survival rate was computed for 220 medically treated
patients. Of these patients, 107 had coronary angiograms (group A) and 113
did not (group B). All had horizontal or downsloping ST depression greater
than or equal to 2 mm during a multistage Bruce protocol treadmill exercise
test. In group A, the overall 5-year survival rate was 74 +/- 5%. Survival
decreased with decreasing duration of exercise: All patients who achieved
stage IV (541 seconds or more) survived, whereas the survival rate was 86
+/- 6% when the patients terminated their exercise during stage III (361 -
540 seconds), 73 +/- 7% when during stage II (181 - 360 seconds) and only
52 +/- 13% when during stage I (180 seconds or less). The mortality was
associated with more severe coronary artery disease, and sudden death was
the main cause of death. Patients in group B had a longer mean exercise
duration than those in group A and, as expected, a higher survival rate (91
+/- 3%, p less than 0.01), which also varied according to the exercise
duration. Among patients with a strongly positive exercise ECG, the
duration of exercise identifies subsets that have different survival rates.
ARTICLES
Survival of patients with a strongly positive exercise electrocardiogram
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