Document Detail

Prognostic significance of exercise stress echocardiography in 3329 outpatients (5-year longitudinal study).
MedLine Citation:
PMID:  17113169     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Appraisal of the risk to which outpatients with chest pain are exposed is a major clinical problem. Up to now, there have been no reports on the prognostic significance of exercise stress echocardiography in this patient cohort. PATIENTS AND METHODS: In order to investigate the prognostic significance of exercise stress echocardiography (SE) in outpatients only, 3329 patients were monitored during a long-term follow-up regarding the occurrence of hard events (cardiac death, myocardial infarction, revascularization). The patients came to the cardiology practice complaining of chest pain. RESULTS: The sensitivity/specificity of SE for hard events was 81.1/92.8 in the first year, that of exercise ECG, 27.4/87.0. During the observation period (5.1+/-1.1 years (median 5.2, 3-7 years)), a total of 446 (13.4%) hard events occurred. In patients with positive SE findings, 262 (61.9%) hard events occurred, in patients with negative SE findings, hard events were rarer (184, 6.3%, p<0.001). In the multivariate analysis, the positive SE finding was the most unambiguous, significant independent predictor of hard events (HR 6.6, CI 5.21-8.25, p<0.001). CONCLUSIONS: In outpatients with chest pains, exercise stress echocardiography is of major prognostic significance (independent of other parameters) and its prognostic reliability is clearly superior to that of the exercise ECG. SE should always be performed in cases with symptoms requiring clarification.
Roman Leischik; Birgit Dworrak; Henning Littwitz; Hartmut Gülker
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Publication Detail:
Type:  Journal Article     Date:  2006-11-16
Journal Detail:
Title:  International journal of cardiology     Volume:  119     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-25     Completed Date:  2007-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  297-305     Citation Subset:  IM    
Universität Witten-Herdecke, Mittelstrasse 13, 58095 Hagen, Germany.
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MeSH Terms
Ambulatory Care
Angina Pectoris / physiopathology*,  ultrasonography*
Cohort Studies
Coronary Angiography
Coronary Stenosis / radiography
Death, Sudden, Cardiac / etiology
Echocardiography, Stress*
Middle Aged
Myocardial Infarction / etiology
Myocardial Revascularization
Sensitivity and Specificity

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