Document Detail


Prognostic value of stress echocardiography in women with high (> or = 80%) probability of coronary artery disease.
MedLine Citation:
PMID:  11524515     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To assess the prognostic significance of stress echocardiography in women with a high probability of coronary artery disease (CAD). SETTING: Secondary and tertiary cardiology unit at a university teaching hospital. PARTICIPANTS: A total of 135 women (mean (SD) age 63 (9) years) with pre-test probability of CAD > or = 80% were selected from a database of patients investigated by treadmill or dobutamine stress echocardiography between 1995 and 1998. MAIN OUTCOME MEASURES: Patients were followed up for occurrence of subsequent cardiac events (cardiac death, myocardial infarction, admission with unstable angina, and revascularisation) using a structured telephone interview and case note review. RESULTS: Each patient had between two and seven (mean 3.5) CAD risk factors and pre-test probability of CAD > or = 80%. Ninety three patients (68.9%) had negative stress echocardiography. Mean (SD) follow up was 20.1 (8.5) months. There were six events in the positive stress echocardiography group (two cardiac deaths, one unstable angina, three revascularisations), and one event in the negative stress echocardiography group. Cox regression analysis showed positive stress echocardiography (p = 0.02) and age (p = 0.03) to be the only univariate predictors and positive stress echocardiography to be the only independent predictor of future cardiac events (relative risk 8.9, confidence interval 1.0 to 76.5, p = 0.04). Cumulative event free survival to 38 months was 98% in the negative stress echocardiography and 50.7% in the positive stress echocardiography groups. CONCLUSION: In women with high pre-test likelihood of CAD: (1) negative stress echocardiography identifies a subgroup with low risk of cardiac events who do not require further invasive investigation and (2) positive stress echocardiography identifies a subgroup with increased risk of subsequent cardiac events.
Authors:
J I Davar; E B Roberts; J G Coghlan; T R Evans; D P Lipkin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Postgraduate medical journal     Volume:  77     ISSN:  0032-5473     ISO Abbreviation:  Postgrad Med J     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-08-28     Completed Date:  2001-09-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0234135     Medline TA:  Postgrad Med J     Country:  England    
Other Details:
Languages:  eng     Pagination:  573-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Royal Free Hospital, Pond Street, London NW3 2QG, UK. josephdavar@rth.nthames.nhs.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Cardiotonic Agents / diagnostic use
Coronary Disease / etiology,  ultrasonography*
Disease-Free Survival
Dobutamine / diagnostic use
Exercise Test
Female
Follow-Up Studies
Humans
Middle Aged
Predictive Value of Tests
Prognosis
Retrospective Studies
Risk Assessment
Risk Factors
Chemical
Reg. No./Substance:
0/Cardiotonic Agents; 34368-04-2/Dobutamine
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