The outcome of 50 consecutive modified predischarge exercise tests after acute myocardial infarction was predicted by three independent observers on the basis of ST segment displacement in the resting pretest 12 lead electrocardiograms. The mean predictive accuracy for the three observers was 82% for a positive test defined as additional ST segment depression or elevation greater than or equal to 0.1 mV, and rose to 94% for a positive test defined as additional ST segment depression greater than or equal to 0.1 mV alone. For the majority of patients, the test result was already apparent in the resting 12 lead electrocardiogram.
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