Document Detail


Comparison of the prognostic value of the stress-recovery index versus standard electrocardiographic criteria in patients with a negative exercise electrocardiogram.
MedLine Citation:
PMID:  17697814     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To verify whether the stress recovery index (SRI) improves risk stratification in patients with a negative exercise electrocardiogram (ECG) using standard criteria, the SRI was derived in 708 consecutive patients with a negative exercise ECG. All-cause mortality and the combination of death or nonfatal myocardial infarction were target end points. The individual effect of clinical and exercise testing data on outcome was evaluated using Cox regression analysis with separate models for each group of variables. Model validation was performed using bootstrap adjusted by degree of optimism in estimates. Survival analysis was performed using a product-limit Kaplan-Meier method. During a 37-month follow-up, 22 deaths and 40 nonfatal acute coronary syndromes occurred. After adjusting for confounding variables, age (hazard ratio 1.62, 95% confidence interval [CI] 1.14 to 2.31 for interquartile difference), hypertension (hazard ratio 1.74, 95% CI 1.04 to 2.89), and SRI (hazard ratio 0.75, 95% CI 0.65 to 0.86 for interquartile difference) were predictive of death or nonfatal myocardial infarction. Moreover, SRI increased the prognostic power of the model on top of clinical and exercise testing variables and provided significant discrimination of survival. In conclusion, the SRI may help refine the prognostic stratification of patients with a negative exercise test result using standard electrocardiographic criteria.
Authors:
Riccardo Bigi; Lauro Cortigiani; Dario Gregori; Cesare Fiorentini
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Publication Detail:
Type:  Journal Article     Date:  2007-06-27
Journal Detail:
Title:  The American journal of cardiology     Volume:  100     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-08-16     Completed Date:  2007-09-27     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  605-9     Citation Subset:  AIM; IM    
Affiliation:
Cardiology, Department of Medicine and Surgery, University School of Medicine, Milan, Italy. riccardo.bigi@unimi.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Cause of Death
Electrocardiography / methods*
Exercise Test
Female
Follow-Up Studies
Humans
Italy / epidemiology
Male
Middle Aged
Myocardial Ischemia / diagnosis,  mortality,  physiopathology*
Outpatients
Predictive Value of Tests
Prognosis
Retrospective Studies
Severity of Illness Index
Stress, Physiological / physiopathology*
Survival Rate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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