A metaanalysis of predischarge risk stratification after acute myocardial infarction with stress electrocardiographic, myocardial perfusion, and ventricular function imaging

The American Journal of Cardiology
L J ShawR M Califf

Abstract

We assessed the relation of abnormal predischarge non-invasive test results to outcomes in postmyocardial infarction patients. We included series published from 1980 to 1995 containing only myocardial infarction patients, enrolling most patients after 1980, testing within 6 weeks of infarction, having follow-up rates > 80%, and having 2 x 2 frequency outcome rates for test results, that were the latest of multiple reports. Sensitivity, specificity, and predictive values were calculated for test results for 1-year outcomes (cardiac death, cardiac death or reinfarction). Univariable and summary odds were calculated for test results. Reports (n = 54) included a total of 19,874 patients and were primarily retrospective (76%) and small series (35% of reports included < 5 deaths). One-year mortality ranged from 2.5% for pharmacologic stress echocardiography to 9.3% for exercise radionuclide angiography. Positive predictive values for most noninvasive risk markers were < 0.10 for cardiac death and < 0.20 for death or reinfarction. Electrocardiographic, symptomatic, and scintigraphic risk markers of ischemia (ST-segment depression, angina, a reversible defect) were less sensitive (< or = 44%) for identifying morbid and fatal outcomes t...Continue Reading

References

Jun 1, 1991·Statistics in Medicine·T C Chalmers
Jan 1, 1990·Medical Decision Making : an International Journal of the Society for Medical Decision Making·D M EddyR Shachter
Apr 1, 1987·Australian and New Zealand Journal of Medicine·D L KucharN Sammel
Jan 1, 1987·Statistics in Medicine·R J Simes
Sep 3, 1983·British Medical Journal·K JenningsD G Julian
Aug 11, 1983·The New England Journal of Medicine·UNKNOWN Multicenter Postinfarction Research Group
Jun 1, 1995·The American Journal of Medicine·B E Marx, A R Feinstein
Jan 1, 1995·Medical Decision Making : an International Journal of the Society for Medical Decision Making·V Hasselblad, D C McCrory
Jul 1, 1994·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·M E van DaeleJ R Roelandt
Aug 7, 1993·BMJ : British Medical Journal·R StevensonA D Timmis

❮ Previous
Next ❯

Citations

Feb 17, 2001·The American Journal of Cardiology·R J Gibbons, D L Kawalsky
Oct 28, 2010·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Charaslak Charoenpanichkit, W Gregory Hundley
Jun 4, 2011·Annals of Cardiac Anaesthesia·Ahmed Fathala, Walid Hassan
Mar 26, 2008·Circulation Journal : Official Journal of the Japanese Circulation Society·Shinro MatsuoUNKNOWN J-ACCESS Investigators
Jun 26, 2001·Journal of Internal Medicine·M Jensen-UrstadJ Höjer
Oct 4, 2007·Journal of the American Geriatrics Society·Karol WatsonMatthew Budoff
Jun 4, 2015·Research Synthesis Methods·Pablo E Verde, Christian Ohmann
Jul 14, 2006·International Journal of Cardiology·John P Higgins, Johanna A Higgins
Oct 28, 2004·Nutrition & Metabolism·Christos PitsavosChristodoulos Stefanadis
Mar 25, 2009·Maturitas·Tiny HoekstraYvonne T van der Schouw
Aug 16, 2008·Metabolism: Clinical and Experimental·Hilda J I de JongJohanna M Geleijnse
Dec 5, 2002·Journal of Cardiopulmonary Rehabilitation·Afshin GhayoumiVictor F Froelicher
Dec 25, 2004·European Heart Journal·Mats Börjesson, Mikael Dellborg
Aug 16, 2003·Clinical Cardiology·Riccardo BigiAlessandro Desideri
Jul 28, 2005·The International Journal of Cardiovascular Imaging·Eliana Reyes
Dec 6, 2005·Journal of Cardiopulmonary Rehabilitation·Vaclav ChaloupkaFrantisek Jedlicka
Jun 29, 2011·Journal of Cardiovascular Medicine·Catherine SzymanskiPatrizio Lancellotti
Nov 5, 2003·Current Opinion in Cardiology·Kameswari Maganti, Vera H Rigolin
Apr 25, 2000·The Medical Journal of Australia·M Jelinek

❮ Previous
Next ❯

Related Concepts

Related Feeds

Cardiovascular Diseases: Risk Factors

Cardiovascular disease is a significant health concern. Risk factors include hypertension, obesity, dyslipidemia and smoking. Women who are postmenopausal are at an increased risk of heart disease. Here is the latest research for risk factors of cardiovascular disease.