Document Detail

A simple clinical score accurately predicts outcome in a community-based population undergoing stress testing.
MedLine Citation:
PMID:  16084179     Owner:  NLM     Status:  MEDLINE    
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.
Todd D Miller; Veronique L Roger; David O Hodge; Raymond J Gibbons
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Publication Detail:
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:
Title:  The American journal of medicine     Volume:  118     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2005 Aug 
Date Detail:
Created Date:  2005-08-08     Completed Date:  2005-09-13     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  866-72     Citation Subset:  AIM; IM    
Department of Internal Medicine and Cardiovascular Diseases, Mayo Clinic, Rochester, Minn 55905, USA.
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MeSH Terms
Coronary Angiography
Coronary Artery Disease / diagnosis,  mortality*,  therapy
Exercise Test*
Follow-Up Studies
Logistic Models
Middle Aged
Minnesota / epidemiology
Myocardial Infarction / mortality*,  therapy
Myocardial Revascularization
Outcome Assessment (Health Care)*
Risk Assessment
Severity of Illness Index*
Survival Rate
Grant Support
Comment In:
Am J Med. 2006 Jul;119(7):e13; author reply e15   [PMID:  16828614 ]

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