Document Detail

Prognostic value of predischarge dobutamine stress echocardiography in chest pain patients with a negative cardiac troponin T.
MedLine Citation:
PMID:  12598071     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: We prospectively studied the prognostic value of predischarge dobutamine stress echocardiography (DSE) in low-risk chest pain patients with a normal or nondiagnostic electrocardiogram (ECG) and a negative serial troponin T. BACKGROUND: Noninvasive stress testing is recommended before discharge or within 72 h in patients with low-risk chest pain. The prognostic value of immediate DSE has not been studied in a blinded, prospective fashion. METHODS: Patients presenting at the emergency room within 6 h of symptom onset and a normal or nondiagnostic ECG were eligible. Dobutamine stress echocardiography was performed after unstable coronary artery disease was ruled out by a standard rule-out protocol and a negative serial troponin T; the occurrence of any new wall motion abnormality was considered positive. Results were kept blinded. End points were cardiac death, myocardial infarction, rehospitalization for unstable angina or revascularization. RESULTS: In total, 377 patients were included. There were 2 deaths, 2 myocardial infarctions, 8 rehospitalization for unstable angina, and 10 revascularizations at six-month follow-up. The end points occurred in 8/26 (30.8%) patients with a positive versus 14/351 (4.0%) patients with a negative DSE (odds ratio, 10.7; 95% confidence interval, 4.0 to 28.8; p < 0.0001). By multivariate analysis, DSE remained a predictor of end points (p < 0.0001). CONCLUSIONS: A predischarge DSE had important, independent prognostic value in low-risk, troponin negative, chest pain patients.
Radha Bholasingh; Jan Hein Cornel; Otto Kamp; Jan P van Straalen; Gerard T Sanders; Jan G P Tijssen; Victor A W M Umans; Cees A Visser; Robbert J de Winter
Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  41     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-24     Completed Date:  2003-03-12     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  596-602     Citation Subset:  AIM; IM    
Department of Cardiology, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
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MeSH Terms
Angina Pectoris / blood*,  physiopathology,  ultrasonography*
Cohort Studies
Double-Blind Method
Echocardiography, Stress*
Follow-Up Studies
Middle Aged
Outcome Assessment (Health Care)
Prospective Studies
Reproducibility of Results
Time Factors
Troponin T / blood*
Reg. No./Substance:
0/Troponin T

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

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