SAFETY OF PREDISCHARGE EXERCISE TREADMIL TEST AFTER DIFFERENT TYPES OF ACUTE MYOCARDIAL INFARCTION
Syed Fasih Ahmed Hashmi, Sumaira Shaikh, Anwar Shaikh, Jamrose Durrani, Zaheer Ahmed,
*Zulfiqar Ali Qutrio Baloch
Objective: To assess the safety of performing pre-discharge treadmill after various type of acute myocardial infarction. Patients and Methods: This study of 3 months, starting from August to October 2015 was performed at Liquate University of Medical And Health Sciences Hospital, Hyderabad. The study population was the patients who were treated as the case of ST Elevation Myocardial infarction and diagnosed according to WHO criteria while the technique was used in the study was Non-probability Sampling more appropriately convenience sampling. The inclusion criteria of the study were ejection fraction > 40% before discharge, systolic blood pressure range i.e. 110 to 180mmHg, diastolic blood pressure range i.e. 90 to 110mmHg, ability to ambulate in the ward, absence of heart failure sign, absence of any orthopedic problems that preclude exercise, patients who received Streptokinase therapy after acute myocardial infarction. Exercise treadmill tests were performed with patients in fasting state on treadmill machine with modified Bruce protocol. The analyses were completed. In the analysis, data obtained from the ETT response of predischarge patients who have recent attack of MI and having certain risk factors. Accordingly on the basis of study a series of variables and chi-square statistical test was applied on categorical variables with p-value ≤0.05 was considered as significant. Results: The mean age was 47.87 in which 36.6% anterior MI, 56.1% inferior, 12.2% lateral MI, 14.6% posterior MI and 14.6% other types of MI. Different association was found between type of MI and results found during treadmill test, that was anterior MI with statistical significant (p-value 0.010) with Angina pain, Inferior MI with Statistical significant (p-value 0.010) with Angina pain and Lateral MI with statistical significant (p-value 0.027) with ST depression. Statistical correlations between Anterior MI and Angina pain was found with p-value of 0.009 with weak positive identity i.e. 0.402, similarly with inferior MI and Angina Pain with p-value of 0.009 with weak negative identity i.e. -0.402 and lastly statistical correlation was found between lateral MI and ST depression with p-value of 0.027 with weak positive identity i.e. 0.346. No any other statistical correlation was found between response to other type of MI and Risk factors. Conclusion: There is significant risk in lateral MI to perform treadmill because of ST depression. In case of Anterior MI the relation of Angina pain is much more diverse and showed a relative risk to perform treadmill.
Keywords: discharge, systolic blood pressure range, ETT response.
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