Document Detail

Comparison of exercise echocardiography and the Duke treadmill score for risk stratification in patients with known or suspected coronary artery disease and normal resting electrocardiogram.
MedLine Citation:
PMID:  16781248     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although exercise echocardiography (EE) is not clearly indicated in patients with normal electrocardiogram (ECG) as the first evaluation, there is a lack of data regarding its superiority over the Duke score for prognosis. We investigate whether EE has incremental value over the Duke score for predicting outcome in patients with normal ECG. METHODS: One thousand six hundred forty-seven patients with interpretable ECG referred for EE were followed up for 2.5 +/- 1.4 years. There were 58 hard events (myocardial infarction or cardiovascular death). RESULTS: There were 38 events in 735 patients with abnormal EE versus 20 events in 912 with normal EE (P < .0001). The Duke score, resting wall motion score index, and ischemia were independently associated to events (incremental P value of EE = .03). The Duke score allowed stratification of patients with abnormal EE (P = .001) or ischemia (P = .01) into different risk categories but did not stratify patients without these characteristics. Exercise echocardiography variables stratified patients with the low Duke score (left anterior descending artery territory P = .04, left anterior descending artery ischemia P = .03) and with the intermediate Duke score (abnormal EE P = .005, necrosis P = .0009, ischemia P = .004, resting ejection fraction P < .00001, resting wall motion score index P < .00001, peak ejection fraction P < .00001, peak wall motion score index P < .0001, number of territories P = .002, left anterior descending artery territory P = .001, and left anterior descending artery ischemia P = .002) but did not with the high Duke score. CONCLUSIONS: Exercise echocardiography has incremental value over clinical variables, the Duke score, and resting echocardiography for the prediction of hard cardiovascular events in patients with normal resting ECG.
Jesús Peteiro; Lorenzo Monserrrat; Miriam Piñeiro; Ramon Calviño; Jose Manuel Vazquez; Javier Mariñas; Alfonso Castro-Beiras
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  151     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2006 Jun 
Date Detail:
Created Date:  2006-06-19     Completed Date:  2006-07-25     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1324.e1-10     Citation Subset:  AIM; IM    
Unit of Echocardiography, Juan Canalejo Hospital, A Coruña, Spain.
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MeSH Terms
Coronary Artery Disease / mortality,  physiopathology*,  ultrasonography*
Echocardiography, Stress*
Middle Aged
Risk Assessment

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