Safety of stress testing during the evolution of unstable angina pectoris or non-ST-elevation myocardial infarction
ABSTRACT Patients (n = 1,106) were chosen from the conservative arm of the Treat Angina with aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis In Myocardial Infarction (TACTICS-TIMI) 18 trial. Only 1 patient had a myocardial infarction and another died on the day of stress testing (mortality 0.12%). In patients with unstable angina pectoris or non-ST-elevation myocardial infarction treated with aspirin, heparin, and tirofiban, performance of an exercise or a pharmacologic stress test in selected patients within 48 to 72 hours after admission appears to be associated with a low risk of complications.
- The American Journal of Cardiology 01/2005; 94(12):1534-6. DOI:10.1016/j.amjcard.2004.08.032 · 3.43 Impact Factor
- Arquivos Brasileiros de Cardiologia 01/2008; 90(3). DOI:10.1590/S0066-782X2008000300007 · 1.12 Impact Factor
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ABSTRACT: Stable angina pectoris is defi ned as chest pain that is substernal, brought on by exertion, and relived with rest or nitroglycerin. The pain usually radiates to the left arm, jaw, or back. Unstable angina (UA) is angina pectoris that is either occurring at rest, new in onset, or increasing in intensity. New-onset unstable angina is severe angina (Canadian Cardiovascular Society class III [Table 8.1] or greater) that is less than 1 month old. Crescendo angina is angina increasing in intensity, duration, or frequency to at least Canadian Cardiovascular Society (CCS) class III. Rest angina is angina occurring at rest and usually lasting greater than 20 minutes . By defi nition, UA patients have negative cardiac biomarkers (troponins, creatine kinase [CK]-MB) with or without ST changes. Because of the similar pathophysiology between UA and non—ST-segment elevation myocardial infarction (NSTEMI), their treatment often overlaps. When following this treatment algorithm, it is important to remember that patients with UA tend to be at lower risk of major adverse outcomes than those patients with NSTEMI.06/2009: pages 73-85;