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Weiner DA, McCabe C, Klein MD, et al. ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm. Circulation. 1978;58(5):887-91doi: 10.1161/01.cir.58.5.887.
Weiner, D. A., McCabe, C., Klein, M. D., & Ryan, T. J. (1978). ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm. Circulation, 58(5), 887-91. https://doi.org/10.1161/01.cir.58.5.887
Weiner, D A, et al. "ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm." Circulation vol. 58,5 (1978): 887-91. doi: https://doi.org/10.1161/01.cir.58.5.887
Weiner DA, McCabe C, Klein MD, Ryan TJ. ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm. Circulation. 1978 Nov;58(5):887-91. doi: 10.1161/01.cir.58.5.887. PMID: 699255.
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Circulation. 1978 Nov;58(5):887-91. doi: 10.1161/01.cir.58.5.887.

ST segment changes post-infarction: predictive value for multivessel coronary disease and left ventricular aneurysm.

Circulation

D A Weiner, C McCabe, M D Klein, T J Ryan

PMID: 699255 DOI: 10.1161/01.cir.58.5.887

Abstract

To ascertain whether exercise testing might predict multivessel coronary disease and left ventricular aneurysm after a myocardial infarction, 154 patients with a single documented myocardial infarction who had both exercise testing and coronary angiography were grouped according to whether they had greater than or equal to 1 mm ST depression, greater than or equal to 1 mm ST elevation, or neither during exercise testing: 83 patients developed ST depression alone (group 1); 22 patients had ST elevation with concomitant ST depression in other leads (group 2); 19 patients had ST elevation alone (group 3); and 30 patients had no ST changes (group 4). Multivessel disease, defined as greater than or equal to 70% luminal narrowing in two or more coronary vessels, was present in 76% (63 of 83) of group 1, 91% (20 of 22) of group 2, 21% (four of 19) of group 3, and 13% (four of 30) of group 4. A left ventricular aneurysm was present in 31% (26 of 83) of group 1, 68% (15 of 22) of group 2, 79% (15 of 19) of group 3, and 40% (12 to 30) of group 1. We conclude that ST changes during exercise testing in patients after a myocardial infarction can reliably predict the extent of coronary disease and the presence of a left ventricular aneurysm; ST depression with or without ST elevation predicts multivessel disease; ST elevation alone or a negative exercise test suggests single vessel involvement; and ST elevation with or without ST depression predicts left ventricular aneurysm.

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