Document Detail

The prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography: a meta-analysis.
MedLine Citation:
PMID:  17222734     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The purpose of this work was to determine the prognostic value of normal exercise myocardial perfusion imaging (MPI) tests and exercise echocardiography tests, and to determine the prognostic value of these imaging modalities in women and men. BACKGROUND: Exercise MPI and exercise echocardiography provide prognostic information that is useful in the risk stratification of patients with suspected coronary artery disease (CAD). METHODS: We searched the PubMed, Cochrane, and DARE databases between January 1990 and May 2005, and reviewed bibliographies of articles obtained. We included prospective cohort studies of subjects who underwent exercise MPI or exercise echocardiography for known or suspected CAD, and provided data on primary outcomes of myocardial infarction (MI) and cardiac death with at least 3 months of follow-up. Secondary outcomes (unstable angina, revascularization procedures) were abstracted if provided. Studies performed exclusively in patients with CAD were excluded. RESULTS: The negative predictive value (NPV) for MI and cardiac death was 98.8% (95% confidence interval [CI] 98.5 to 99.0) over 36 months of follow-up for MPI, and 98.4% (95% CI 97.9 to 98.9) over 33 months for echocardiography. The corresponding annualized event rates were 0.45% per year for MPI and 0.54% per year for echocardiography. In subgroup analyses, annualized event rates were <1% for each MPI isotope, and were similar for women and men. For secondary events, MPI and echocardiography had annualized event rates of 1.25% and 0.95%, respectively. CONCLUSIONS: Both exercise MPI and exercise echocardiography have high NPVs for primary and secondary cardiac events. The prognostic utility of both modalities is similar for both men and women.
Louise D Metz; Mary Beattie; Robert Hom; Rita F Redberg; Deborah Grady; Kirsten E Fleischmann
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.; Review     Date:  2006-12-29
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  49     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-15     Completed Date:  2007-02-07     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  227-37     Citation Subset:  AIM; IM    
Department of Medicine, New York University School of Medicine, New York, New York, USA.
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MeSH Terms
Age Factors
Cohort Studies
Coronary Disease / mortality,  radionuclide imaging*,  ultrasonography*
Echocardiography, Stress / methods*
Middle Aged
Multivariate Analysis
Predictive Value of Tests
Prospective Studies
Risk Assessment
Sensitivity and Specificity
Sex Factors
Survival Analysis
Tomography, Emission-Computed, Single-Photon
Grant Support
N0. 290-97-0013//PHS HHS
Comment In:
J Am Coll Cardiol. 2007 Jan 16;49(2):238-9   [PMID:  17222735 ]

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