Stress echocardiography for risk stratification of patients with chest pain and normal or slightly narrowed coronary arteries.
One hundred twenty-five patients (60 +/- 10 years old, 60 women) with known (35, previous myocardial infarction) or suspected (90) coronary artery disease (CAD) and no more than 50% coronary stenoses underwent pharmacologic (48 dipyridamole and 77 dobutamine) stress echocardiography (SE) and prospective follow-up (36 +/- 22 months) for cardiac death, nonfatal infarction, and unstable angina. The ability of clinical and SE variables to predict the outcome was assessed by the Cox model. A significant increase in the global chi-square of the model indicated an incremental prognostic value. Nine events occurred: 2 fatal and 5 nonfatal infarctions and 2 hospitalizations for unstable angina. Hypertension, positive SE, and peak wall motion score index were multivariate predictors of outcome, but SE provided an 87.5% increase in the global chi-square (P <.001). Patients with positive SE had a significantly lower event-free survival compared with those with negative SE. Therefore, we conclude that SE provides incremental prognostic information in patients with chest pain without critical coronary artery disease.
Bigi
Riccardo
R
Cardiovascular Research Foundation, Castelfranco Veneto, Italy. rbigi@tiscalinet.it
Cortigiani
Lauro
L
Bax
Jeroen J
JJ
Colombo
Paola
P
Desideri
Alessandro
A
Sponzilli
Carlo
C
Fiorentini
Cesare
C
D000367:Age Factors; D000368:Aged; D002637:Chest Pain / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology; D004176:Dipyridamole; D018572:Disease-Free Survival; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014665:Vasodilator Agents
D014665:Vasodilator Agents; D004176:Dipyridamole