title: Comparison of 5-Year Outcomes for Patients With Coronary Artery Disease in Groups With and Without Revascularization With Different Results of Stress Echocardiography.
abstract: BACKGROUND
  There is conflicting data in contemporary literature concerning the best way to treat patients with stable coronary artery disease; specifically, whether medical treatment alone or invasive strategies combined with medical treatment are better. The purpose of this study was to evaluate the clinical outcomes of patients with and without revascularization after stress echocardiography and to create formulas for detecting patients with a very high risk of cardiac death/major adverse cardiac event (MACE) in their present conditions.
  
  
  METHODS
  We assessed 323 patients (53.9 ± 8.4 years, 247 men), undergoing upright bicycle stress echocardiography in 2006 - 2007. During a median follow-up of 5.2 ± 0.2 years, 21 cardiovascular and 5 confirmed non-cardiac deaths occurred. Eighty-three patients underwent revascularization.
  
  
  RESULTS
  Stress echocardiography was normal in 32% and abnormal in 68%. All the patients with CAD were prescribed acetylsalicylic acid, statins, beta-blockers and ACE inhibitors. Eighty-seven percents of the patients took medication regularly. The percentage taking medication didn't significantly differ in the subgroups. Two formulas were created for detecting a very high risk of cardiac death (25%) or MACE (68%) within 5 years. All the patients with abnormal stress tests were divided into two subgroups: 80 patients with revascularization and 138 subjects without revascularization. There was a significant difference in 5 year cardiac mortality if the patients had an index of wall motion abnormality (IWMA) after exercise greater than or equal to 1.3.
  
  
  CONCLUSIONS
  It is possible to identify during stress echocardiography subjects with a very high risk for cardiac death/MACE. Patients with IWMA ≥ 1.3 had improved outcomes following revascularization.
authors.affiliation: Cardiocenter "Medika", St. Petersburg, Russian Federation.
authors.forename: Angela
authors.initials: A
authors.lastname: Zagatina
authors.affiliation: Leningrad Regional Cardiologic Dispensary, St. Petersburg, Russian Federation.
authors.forename: Ludmila
authors.initials: L
authors.lastname: Krylova
authors.affiliation: Cardiocenter "Medika", St. Petersburg, Russian Federation.
authors.forename: Yuliya
authors.initials: Y
authors.lastname: Vareldzhan
authors.affiliation: Leningrad Regional Cardiologic Dispensary, St. Petersburg, Russian Federation.
authors.forename: Tatyana V
authors.initials: TV
authors.lastname: Tyurina
authors.affiliation: Northwestern Medical University n.a. I.I. Mechnikov, St. Petersburg, Russian Federation.
authors.forename: Olga
authors.initials: O
authors.lastname: Clitsenko
authors.affiliation: Cardiocenter "Medika", St. Petersburg, Russian Federation.
authors.forename: Nadezhda
authors.initials: N
authors.lastname: Zhuravskaya
keywords: Exercise echo; Outcomes after stress echocardiography; Prognosis; Stable coronary artery disease; Stress echo