Document Detail


The Stress-Recovery Index for the risk stratification of women with typical chest pain.
MedLine Citation:
PMID:  17692413     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To prospectively assess the prognostic value of the Stress-Recovery Index (SRI) in women with typical chest pain. METHODS: 165 women without known coronary artery disease, who complained of typical chest pain, were exercise tested and prospectively followed-up for the occurrence of cardiac death and nonfatal myocardial infarction. SRI, defined as the difference in absolute values between the area of heart rate-adjusted ST-segment depression during exercise and recovery, was derived in all. Clinical data, resting ejection fraction, and exercise testing data were entered into a sequential Cox's model; SRI was entered last. Model validation was performed by bootstrap adjusted by the degree of optimism in estimates. Survival curves were set up using Kaplan-Meier method and compared by the log-rank test. RESULTS: During a median follow-up time of 42 months, 19 events (14 cardiac deaths and 5 nonfatal myocardial infarction) were observed. Age (hazard ratio 3.58, 95% CI 0.87-15) and SRI (hazard ratio 0.62, 95% CI 0.42-0.92) were multivariate predictors of outcome. However, the addition of SRI increased the prognostic power of the model on top of clinical and exercise testing variables, as demonstrated by the significant (p=0.003) increase of the area under the ROC curve of the risk function. Survival analysis showed ascending SRI quartiles to identify a significant (p=0.005) increase in event-free survival. CONCLUSIONS: SRI is of value in predicting outcome of women with typical chest pain and provides additional prognostic information on the top of clinical and standard exercise testing data.
Authors:
Riccardo Bigi; Lauro Cortigiani; Dario Gregori; Cesare Fiorentini
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Publication Detail:
Type:  Journal Article     Date:  2007-08-09
Journal Detail:
Title:  International journal of cardiology     Volume:  127     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-27     Completed Date:  2008-07-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  64-9     Citation Subset:  IM    
Affiliation:
Cardiology, Department of Medicine and Surgery, University School of Medicine, Via A. di Rudinì 8- 20142 Milano, Italy. Riccardo.Bigi@unimi.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Chest Pain / classification*,  physiopathology
Electrocardiography
Exercise Test*
Female
Humans
Middle Aged
Myocardial Infarction / mortality
Predictive Value of Tests
Prognosis
Proportional Hazards Models
Prospective Studies
ROC Curve
Risk Assessment
Survival Analysis

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


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