Cardiac catheterization is extremely important in defining prognosis and determining the approach to therapy in many subsets of patients with a recent myocardial infarction in addition to those undergoing early thrombolytic therapy or operation for potentially lethal complication of acute myocardial infarction. Such an approach seems prudent for most patients with nontransmural myocardial infarctions, patients under age 40 with a first infarction, and patients with post-infarction angina. In patients with uncomplicated myocardial infarction it is usually possible to separate relatively low-risk and high-risk patients, with risk stratification depending upon the results of low-level early post-infarction, symptom-limited electrocardiographic exercise testing and other noninvasive methods when indicated. Such an approach does not preclude the necessity of assessing each patient as an individual as well as within the subgroup in which he or she belongs.
