| Prognostic value of a nine-minute treadmill test in patients undergoing myocardial perfusion scintigraphy. | |
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MedLine Citation:
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PMID: 21059431 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Exercise capacity is an important predictor of risk in known or suspected coronary disease. A negative treadmill test to 9 minutes of the Bruce protocol is often used in the screening process for vocational licensing; myocardial perfusion scintigraphy is an alternative for those unable to exercise, with apparent incremental prognostic power above exercise testing alone. We compared exercise test and myocardial perfusion scintigraphic (MPS) findings and risk of hard cardiac events (median 4 years) in patients completing ≥ 9-minute treadmill exercise. Patients undergoing myocardial perfusion scintigraphy who completed a 9-minute Bruce protocol exercise were identified over a 2-year period. Follow-up was performed by telephone, with case-note review when necessary; this was 97% complete. Five hundred sixteen patients were identified (73% men, median age 53 year). One hundred eighty-one (35%) had known coronary disease. One hundred forty-nine (29%) had a "high-risk" exercise test result (limiting chest pain or ST-segment depression), and 69 (13%) had high-risk MPS findings (>10% myocardium ischemic or ejection fraction <40%). Of 367 patients with a reassuring exercise test result, 38 (10.4%) had high-risk MPS findings. Of 149 with a high-risk exercise test, 118 (79%) had reassuring MPS findings. At median follow-up of 49 months, there were 8 cardiac events (1.6%). Only 2 patients with high-risk exercise test results (1.4%) and 1 with high-risk MPS findings (1.5%) had an event. In conclusion, for patients able to manage a 9-minute Bruce protocol, presence/absence of symptoms or electrocardiographic changes is a poor predictor of MPS findings. Irrespective of test findings, however, subsequent cardiac risk is extremely low. Ability to complete a 9-minute Bruce protocol treadmill exercise may itself provide adequate prognostic reassurance for most purposes. |
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Authors:
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Andrew J Marshall; Fiona Hutchings; Alycia J James; Andrew D Kelion |
Publication Detail:
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Type: Comparative Study; Journal Article Date: 2010-09-23 |
Journal Detail:
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Title: The American journal of cardiology Volume: 106 ISSN: 1879-1913 ISO Abbreviation: Am. J. Cardiol. Publication Date: 2010 Nov |
Date Detail:
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Created Date: 2010-11-09 Completed Date: 2010-12-02 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 1423-8 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2010 Elsevier Inc. All rights reserved. |
Affiliation:
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Nuclear Medicine Department, Harefield Hospital, Royal Brompton & Harefield NHS Trust, Middlesex, United Kingdom. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Coronary Artery Disease / diagnosis* Exercise Test* Female Humans Male Middle Aged Myocardial Perfusion Imaging* Prognosis Retrospective Studies Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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