Conclusion

Using mostly data from the thrombolytic era, a logical sequence of clinical and noninvasive test procedures has been provided to risk-stratify postinfarct survivors into high and lower risk populations. The highest risk patients should be considered for early coronary angiography and revascularization therapy if clinically indicated, and the lowest risk patients could be managed medically. However, all risk stratification algorithms that are developed based on noninvasive testing will continue to evolve as ongoing clinical outcome studies and consensus statements are tested. Presently, the strategy given in Fig. 13

Fig. 13. Overall strategy to risk-stratify postinfarct survivors and identify optimal candidates for cardiac catheterization or continue medical management. Reproduced with permission from ref. 57.

and Table 1 can be used to assess cardiac risk after AMI in the postthrombolytic/ direct angioplasty era.

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