[Prognostic value of exercise gamma-angiography in coronary insufficiency].
The predictive value for cardiac events in stable coronary artery disease was analysed with resting and exercise radionuclide angiography and conventional exercise stress testing under medical therapy. The population comprised 93 men and 12 women, followed up for 1 to 8 years (mean 51 months). The patients were divided into two groups. Group I without cardiac events; Group II including spontaneous complications and myocardial revascularisations. The analysis was performed at 2 years and at the end of follow-up. At 2 years, 30 events (15 spontaneous complications, 15 revascularisations) were observed, and at the end of follow-up, there were 61 uncomplicated outcomes and 44 cardiac events (22 spontaneous complications, 22 revascularisations). Two independent prognostic factors distinguishing patients in Group I from those in Group II were identified at 2 years and at the end of the study: exercise EF and occurrence of exercise (on: chest pain on exercise) chest pain. Four parameters were significantly different between the two groups at 2 years: exercise EF, resting EF, difference between exercise-resting EF (all p < 0.005) and duration of exercise testing (p = 0.04). The 3 radionuclide parameters remained different between the 2 groups as well as chest pain on exercise stress testing (p = 0.03) throughout the study. The predictive value of these parameters depended on the type of cardiac event. The exercise EF was the best predictive factor of cardiac death. Pain and ST depression on exercise ECG were the best predictive factors for myocardial revascularisation. In 12 patients undergoing myocardial revascularisation, the clearest improvement was observed in exercise EF (p = 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Service de cardiologie, hôpital de Bicêtre, Le Kremlin-Bicêtre.
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S
Witchitz
J N
JN
Talbot
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A
Boubaker
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging*; D016757:Death, Sudden, Cardiac / Q000517:prevention & control; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009204:Myocardial Revascularization; D005082:Physical Exertion; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011875:Radionuclide Angiography; D012680:Sensitivity and Specificity
Valeur pronostique de la gamma-angiographie d'effort dans l'insuffisance coronarienne.