[Early ergometric test and rehabilitation after myocardial infarct in young adults: results and prognostic significance].
A maximal, symptom-limited exercise test was performed 4 weeks after an acute myocardial infarction in 108 subjects aged less than 40. All the patients were afterwards engaged in a 6 weeks supervised rehabilitation program. Following the rehabilitation, 99 patients underwent programmed controls for a mean period of 23.4 +/- 16 months. Anamnestic data, site of the infarction, early exercise test response, rehabilitation results were statistically evaluated. They were compared with the follow-up data to estimate their predictive value of late cardiac events. Only the exercise testing data were found to be of prognostic significance. In fact, 77.8% of patients with ischemic response to the test had new cardiac events in the follow-up period. The percentage of late cardiac events was 26.7% in patients with hypotensive response and 8.4% in patients with normal response. The ischemic response was found to be more frequent in patients with inferior myocardial infarction. The highest rate of new cardiac events (86%) occurred in patients with inferior infarction and ischemic response to the early exercise test. An early exercise test seems to be of value to assess the prognosis after a myocardial infarction in young men. An ischemic response is a reliable sign of a poor prognosis; on the other hand, a normal response to the test does not exclude the possibility of late cardiac events, which may occur in about 10% of these patients.