| Dipyridamole stress echocardiography stratifies outcomes of asymptomatic patients with recent myocardial revascularization. | |
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MedLine Citation:
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PMID: 18157613 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Patients with previous myocardial revascularization, even if symptom-free, remain at risk of subsequent cardiac events, so that a non-invasive tool able to stratify this population is wishful. OBJECTIVES: To assess the prognostic value of dipyridamole stress echocardiography (DipSE) in a population of asymptomatic patients following complete myocardial revascularization, either by coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI). METHODS: We retrospectively evaluated 104 consecutive symptom-free patients (mean age 67+/-9.3 years, 75 males) with recent (<12 months) complete myocardial revascularization (48% PCI, 52% CABG) undergoing DipSE. Ischemia was defined as the onset of a new or worsening wall motion abnormality during DipSE. The composite end point of the study was cardiac death and non-fatal acute coronary syndrome. RESULTS: Myocardial ischemia was identified in 23 patients (22.1%). During a mean follow up of 21 months, 7 (30.4%) out of these patients suffered cardiac events. Among the remaining 81 patients (77.9%) with negative DipSE results, 7 (8.6%) experienced cardiac events. At multivariable analysis only a positive DipSE (odds ratio 3.9, P=0.03), wall motion score index at peak of stress (OR 3.6, P=0.04) and a prior myocardial infarction (odds ratio 3.5, P=0.04) achieved statistical significance for cardiac events. Moreover, DipSE effectively stratified patients into a high and low risk group according to presence of inducible ischemia (event rate per year 16% vs 4.8%, P=0.02). CONCLUSIONS: DipSE yields appropriate risk stratification and provides incremental prognostic value over clinical variables even in asymptomatic patients with prior complete myocardial revascularization. A negative DipSE portends a benign prognosis (<5% event rate/year) in such population. |
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Authors:
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Andrea Rossi; Tiziano Moccetti; Francesco Faletra; Paolo Cattaneo; Mariagrazia Rossi; Elena Pasotti; Cecilia Fantoni; Claudio Anzà; Massimo Baravelli |
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Publication Detail:
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Type: Journal Article Date: 2007-12-22 |
Journal Detail:
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Title: The international journal of cardiovascular imaging Volume: 24 ISSN: 1569-5794 ISO Abbreviation: Int J Cardiovasc Imaging Publication Date: 2008 Jun |
Date Detail:
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Created Date: 2008-05-08 Completed Date: 2008-07-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100969716 Medline TA: Int J Cardiovasc Imaging Country: United States |
Other Details:
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Languages: eng Pagination: 495-502 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Cardiocentro Ticino, Lugano, Switzerland. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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etiology*,
mortality,
ultrasonography Aged Angioplasty, Transluminal, Percutaneous Coronary* Coronary Angiography Coronary Artery Bypass* Coronary Artery Disease / complications, mortality, surgery, therapy, ultrasonography* Dipyridamole / diagnostic use* Echocardiography, Stress / methods* Female Humans Male Middle Aged Myocardial Infarction / etiology*, mortality, ultrasonography Odds Ratio Retrospective Studies Risk Assessment Time Factors Treatment Outcome Vasodilator Agents / diagnostic use* |
| Chemical | |
Reg. No./Substance:
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0/Vasodilator Agents; 58-32-2/Dipyridamole |
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