Predictive value of biphasic response during dipyridamole echocardiography test in the low-risk group of patients after acute myocardial infarction.
To investigate whether biphasic response during dipyridamole echocardiography test (DET), which represents viable but potentially ischemic myocardium in the infarcted region, affects prognosis of patients after uncomplicated acute myocardial infarction, we performed high-dose DET in 80 consecutive patients younger than 65 years with first acute myocardial infarction and preserved left ventricular function. Patients were followed up for 27 +/- 12 months for new coronary events. According to DET results all patients were classified into 4 groups: group 1 consisted of 20 patients with biphasic response; group 2 included 14 patients with sustained improvement in regional contractility; group 3 consisted of 24 patients showing no change in contractility; and group 4 included 22 patients with worsening response. Cumulative survival free of total coronary events was significantly lower in group 1 patients compared with all other groups (P < .05). By multivariate Cox analysis biphasic response was the strongest independent predictor of stable angina pectoris (odds ratio = 12.1, P = .0002), followed by hyperlipoproteinemia (odds ratio = 5.9, P = .006). On the other hand, development of acute coronary syndromes could not have been predicted by actual clinical or DET parameters.
Radosavljevic-Radovanovic
Mina
M
Institute of Cardiovascular Diseases, Clinical Center of Serbia, Belgrade, Serbia and Montenegro. miva@arkayu.net
Pokrajcic
Zorana Vasiljevic
ZV
Radovanovic
Nebojsa
N
Beleslin
Branko
B
Marinkovic
Jelena
J
Stankovic
Goran
G
Kostic
Jasna
J
Mitrovic
Predrag
P
Stefanovic
Branislav
B
Karadzic
Ana
A
Ostojic
Miodrag
M
D004176:Dipyridamole; D018572:Disease-Free Survival; D004452:Echocardiography / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D014665:Vasodilator Agents; D015022:Yugoslavia / Q000453:epidemiology
D014665:Vasodilator Agents; D004176:Dipyridamole