Long term favorable prognostic value of negative treadmill echocardiogram in the setting of abnormal treadmill electrocardiogram: a 95 month median duration follow-up study.
BACKGROUND
The aim of this retrospective study was to assess if negative treadmill echocardiographic (NTME) results retained their favorable prognosis over a long period of follow-up (median, 95 months) in the setting of ischemic stress electrocardiographic (ISECG) results.


METHODS
Consecutive patients with NTME results were analyzed as 2 groups (those with ISECG results and those with normal stress electrocardiographic results). Patients were followed up for a median duration of 95 months to identify major adverse cardiac events (MACEs), including all-cause death, myocardial infarction, and coronary revascularization.


RESULTS
Six hundred seventy-seven patients fulfilled the inclusion criteria. Fifty-eight patients had MACEs (8.6%). The annual event rate was 1%. There was an increased unadjusted rate of MACEs among patients with ISECG results (15% vs 8%; P = .025). After adjusting for clinical and stress variables, ISECG results were not independently predictive of MACEs (P = .2). Female gender, prior coronary artery disease, metabolic equivalents achieved, and chest pain at stress were the independent predictors of MACEs.


CONCLUSIONS
Patients with NTME results had excellent long-term outcomes, regardless of ISECG results, over a median 95-month follow-up period. The findings of this study reaffirm the importance of benign long-term outcomes in the setting of good exercise capacity.
Al-Mallah
Mouaz
M
Henry Ford Hospital, Heart and Vascular Institute, Detroit, Michigan, USA.
Alqaisi
Fadi
F
Arafeh
Abdulilah
A
Lakhdar
Rachid
R
Al-Tamsheh
Rania
R
Ananthasubramaniam
Karthik
K
D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging* / Q000401:mortality*; D004452:Echocardiography / Q000706:statistics & numerical data*; D005080:Exercise Test / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008824:Michigan / Q000453:epidemiology; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate