Document Detail


Stress echocardiography for the risk stratification of patients following coronary bypass surgery.
MedLine Citation:
PMID:  19342111     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of the study was to assess the prognostic value of stress echocardiography after surgical revascularization.
METHODS: We evaluated 500 (100 women) patients who had undergone exercise or pharmacological SE after a median of 69 months after coronary artery by-pass grafting (CABG). Of these, 351 (70%) complained of symptoms suggestive of ischemic origin while 149 (30%) were tested for asymptomatic progression of the disease.
RESULTS: SE was positive for ischemia in 196 (39%) patients. During a median follow-up of 25 months, 61 patients died, 33 had a nonfatal myocardial infarction, and 112 underwent late (>3 months) revascularization. Multivariable Cox' regression analysis indicated age (HR=1.04; 95% CI 1.01-1.06; p<0.003), and peak WMSI (HR=3.07; 95% CI 1.96-4.81; p=0.0001) as independent predictors of hard (total mortality and myocardial infarction) events. SE information provided a significant improvement in predictive power of the statistical model (chi-square increase 34%, p<0.0001 for hard and 91%, p<0.0001 for major events, respectively). Survival analysis showed ischemia at SE to be associated with significantly higher hard and major event rate in both symptomatic and asymptomatic patients.
DISCUSSION: SE represents an effective tool for the risk stratification of patients with previous CABG independently of the presence of symptoms suggestive of ischemic origin.
Authors:
Lauro Cortigiani; Riccardo Bigi; Rosa Sicari; Patrizia Landi; Francesco Bovenzi; Eugenio Picano
Publication Detail:
Type:  Journal Article     Date:  2009-04-01
Journal Detail:
Title:  International journal of cardiology     Volume:  143     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2010-12-30     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  337-42     Citation Subset:  IM    
Copyright Information:
Copyright © 2009 Elsevier Ireland Ltd. All rights reserved.
Affiliation:
Division of Cardiology, Campo di Marte Hospital, Lucca, Italy.
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MeSH Terms
Descriptor/Qualifier:
Aged
Coronary Artery Bypass / statistics & numerical data*
Disease Progression
Echocardiography / statistics & numerical data*
Exercise Test / statistics & numerical data*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Ischemia* / epidemiology,  surgery,  ultrasonography
Prognosis
Proportional Hazards Models
Risk Assessment / methods
Risk Factors

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


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