Management of patients with prolonged ischemic chest pain without acute myocardial infarction

Abstract Consecutive patients admitted to a Coronary Care Unit during 1981–1982 were studied. One hundred twenty-eight patients had prolonged ischemic chest pain without developing myocardial infarction. Follow-up information was available in 121 at an average period of 38 months. Thirty-eight patients (32.8%) sustained significant cardiovascular events, including 14 cardiac deaths. Only 15 patients were symptom-free off treatment. Prognosis was best determined from the resting ECG. Transient ST-T wave shifts predicted patients at high risk of further cardiovascular events and allowed selection of a group meriting more intensive treatment.