The prognostic significance of an early occurrence, or recurrence, of angina pectoris after myocardial infarction was studied in 254 patients (221 male, 33 female; mean age 58 +/- 11 years). During the in-hospital rehabilitation program, 41 patients (16%) had anginal pain. The mean follow-up was 21 months (range 12-33 months). Among the 254 patients, 21 died, five had recurrent myocardial infarction, 13 had unstable angina, and 22 underwent aortocoronary bypass surgery. An early recurrence of angina pectoris was predictive of combined (medical + surgical) events (21 patients, P less than 0.05), medical events (11 patients, P less than 0.05) and surgical events (10 patients, P less than 0.001), but failed to predict individual death (six patients), recurrent myocardial infarction (two patients) or unstable angina (three patients). Of the events that occurred in the 254 patients, 34% were predicted by the early recurrence of angina pectoris. Early post-infarction angina was observed more frequently in older patients and patients with previous history of angina pectoris. This represents an important prognostic factor after myocardial infarction, which defines a high-risk group of patients requiring further investigation and appropriate therapeutic approaches.