title: Long Term Outcomes in Stress Echocardiography: Ten Year Follow up of a Cohort in a Single Centre.
abstract: BACKGROUND
  The high service burden for acute admissions and referrals via rapid access chest pain clinics for evaluation of possible coronary artery disease means that many patients are now undergoing an investigation such as stress echocardiography as part of their evaluation. We aimed to see if the reassurance provided by negative stress echocardiography correlates with long-term event free survival.
  
  
  METHODS
  A cohort of all patients who were referred at a single centre for stress echocardiography for diagnosis of coronary artery disease between January 1st 1999 and December 31st 2000 were followed up at least 10 years following theirs stress echocardiogram for further major cardiovascular events and mortality.
  
  
  RESULTS
  A total of 64 patients were identified where records could be obtained for analysis. There were 16 positive scans, 37 negative scans and 11 inconclusive scans. The indeterminacy rate of scans was 17%, the sensitivity rate for detecting significant disease as indexed to invasive angiography was 88 % and the specificity rate compared with angiography was 75%. There were no myocardial infarctions or new diagnoses of heart failure in the negative echocardiogram group. There were seven deaths in the total population and only one death from cardiovascular causes in the negative echocardiogram group.
  
  
  CONCLUSIONS
  Stress echocardiography even in this small group predicts long-term outcomes as well as invasive coronary angiography.
authors.affiliation: University Hospital Aintree NHS Foundation Trust, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK.
authors.forename: Reza
authors.initials: R
authors.lastname: Ashrafi
authors.affiliation: Royal Oldham Hospital NHS, Pennine Acute NHS Trust, Rochdale Road, Oldham, Manchester OL1 2JH, UK.
authors.forename: Ewan
authors.initials: E
authors.lastname: McKay
authors.affiliation: University Hospital Aintree NHS Foundation Trust, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK.
authors.forename: Julia
authors.initials: J
authors.lastname: Jones
authors.affiliation: University Hospital Aintree NHS Foundation Trust, University Hospital Aintree, Lower Lane, Liverpool L9 7AL, UK.
authors.forename: Aham
authors.initials: A
authors.lastname: Amadi
keywords: Angiography; Outcomes; Stress echocardiography