| A simple clinical score accurately predicts outcome in a community-based population undergoing stress testing. | |
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MedLine Citation:
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PMID: 16084179 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE: Scoring systems based on clinical variables are available but not widely applied for evaluating patients with chronic coronary artery disease. The purpose of this study was to validate the prognostic value of a simple clinical scoring system, originally developed in patients referred for a nuclear stress test at a tertiary-care medical center, in a less-selected, community-based population undergoing stress testing for known or suspected coronary artery disease. SUBJECTS AND METHODS: Over a 4-year period, 3546 residents of Olmsted County, Minn, underwent stress testing. A previously developed clinical score was calculated for every patient by assigning 1 point each for: male sex, history of myocardial infarction, typical angina, diabetes, insulin use, and each decade of age beginning at age 40. The associations between the assigned score and clinical endpoints were tested using logistic regression. A previously established cutoff point of 5 was used to establish risk groups. RESULTS: During follow-up (7.6 +/- 2.7 years) there were 363 total deaths, 109 cardiac deaths, and 132 nonfatal myocardial infarctions. The clinical score was strongly associated with overall mortality, cardiac death, and cardiac death/myocardial infarction (P <0.001 for all 3 endpoints). Annual mortality was .6% for the 3076 patients (86%) with a score < or =4, 2.4% for 275 patients (8%) with a score = 5 and 6.2% for the 215 patients (6%) with a score > or =6. CONCLUSIONS: This study enhances the generalizability of this simple clinical score, which was highly effective for risk-stratifying this community-based population undergoing evaluation of chronic coronary artery disease. |
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Authors:
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Todd D Miller; Veronique L Roger; David O Hodge; Raymond J Gibbons |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of medicine Volume: 118 ISSN: 0002-9343 ISO Abbreviation: Am. J. Med. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-08 Completed Date: 2005-09-13 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0267200 Medline TA: Am J Med Country: United States |
Other Details:
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Languages: eng Pagination: 866-72 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine and Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA. miller.todd@mayo.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography Coronary Artery Disease / diagnosis, mortality*, therapy Exercise Test* Female Follow-Up Studies Humans Logistic Models Male Middle Aged Minnesota / epidemiology Myocardial Infarction / mortality*, therapy Myocardial Revascularization Outcome Assessment (Health Care)* Prognosis Risk Assessment Severity of Illness Index* Survival Rate |
| Grant Support | |
ID/Acronym/Agency:
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AR30582/AR/NIAMS NIH HHS; HL 59205/HL/NHLBI NIH HHS |
| Comments/Corrections | |
Comment In:
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Am J Med. 2006 Jul;119(7):e13; author reply e15
[PMID:
16828614
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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