[Risk stratification after uncomplicated myocardial infarct: the usefulness of the echocardiographic-dipyridamole test].
To assess the value and safety of echo-dipyridamole test in risk stratification soon after an uncomplicated acute myocardial infarction, 56 consecutive patients were enrolled in a prospective study with a 1-year follow-up period for new coronary events. Echo-dipyridamole and symptom-limited ECG stress test were performed respectively 14 to 20 days and 4 to 5 weeks after acute event. Echo-dipyridamole test was performed administering 0.84 mg/kg iv of the drug in 10 min: any worsening of left ventricular regional wall motion was considered as a positive test. Up to December 1989, 43 out of 56 patients had their follow-up period completed: the infarction was anterior in 13 (30%), inferior in 22 (51%), non-Q wave in 8 (19%); mean age was 55 +/- 10; basal echocardiographic ejection fraction was 52 +/- 6%. There were no major complications during echo-dipyridamole test. Coronary events occurred in 7 patients (16%): reinfarction in 3, angina in 4; there were no cardiac deaths. A positive echo-dypiridamole test was observed in 12/43 patients (28%); sensitivity versus coronary events was 43%, specificity 75%, negative predictive value 87%. Ten out of 43 patients (23%) had positive and 9/43 (21%) non valuable ECG stress test: sensitivity versus coronary events was 50%, specificity 75%, predictive negative value 88%. The 2 tests showed no significant difference in detecting patients at risk of future coronary events.(ABSTRACT TRUNCATED AT 250 WORDS)
Ugliengo
G
G
Divisione di Cardiologia, Ospedale Civile S Croce, Cuneo.
Margaria
F
F
Meinardi
F
F
Vado
A
A
De Benedictis
N
N
D000328:Adult; D000368:Aged; D004176:Dipyridamole; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D012307:Risk Factors
D004176:Dipyridamole
Stratificazione del rischio dopo infarto miocardico non complicato: utilità del test eco-dipiridamolo.