title: Dobutamine stress echocardiography in the detection of coronary artery disease: importance of the pretest likelihood of disease.
abstract: Although the accuracy of dobutamine stress echocardiography for the detection of coronary artery disease in a high-risk population is known, it has not been well defined for lower risk groups. Two probability groups, high (>75%; n = 199) and intermediate (>10% but < or =75%; n = 118), were studied. Dobutamine stress echocardiography was performed in a standard fashion. Significant coronary artery disease was defined as a >50% luminal diameter stenosis on coronary angiography. The positive predictive accuracy of dobutamine stress echocardiography for the detection of coronary artery disease was greater in the high-probability group (96% vs 86%), as was the sensitivity (89% vs 78%), whereas the negative predictive value was greater in the intermediate-probability group (50% vs 23%), as was the specificity (63% vs 50%). Dobutamine stress echocardiography does have a diagnostic role in the evaluation of patients with an intermediate probability of coronary artery disease.
authors.affiliation: Cardiovascular Research Group, Mater Misericordiae Hospital, Dublin, Ireland.
authors.forename: T G
authors.initials: TG
authors.lastname: Hennessy
authors.forename: M B
authors.initials: MB
authors.lastname: Codd
authors.forename: G
authors.initials: G
authors.lastname: Kane
authors.forename: C
authors.initials: C
authors.lastname: McCarthy
authors.forename: H A
authors.initials: HA
authors.lastname: McCann
authors.forename: D D
authors.initials: DD
authors.lastname: Sugrue
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D004280:Dobutamine; D004452:Echocardiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012306:Risk; D012680:Sensitivity and Specificity; D013566:Sympathomimetics
chemical_list: D013566:Sympathomimetics; D004280:Dobutamine