Prognostic implications of a normal dobutamine-atropine stress echocardiogram in patients with chest pain

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
M L GeleijnseP Fioretti

Abstract

To assess the prognostic significance of a normal dobutamine-atropine stress echocardiogram in relation to the pretest probability of coronary artery disease (CAD), 200 consecutive patients (86 men and 114 women, mean [SD] age 59 [13] years) with a stable chest pain syndrome and a normal dobutamine-atropine stress echocardiogram were followed-up for 21 +/- 16 months. Outcome events were cardiac death, non-fatal myocardial infarction, and coronary revascularization procedures. Low (<10%), intermediate (10% to 80%), and high (>80%) pretest probabilities of CAD were present in 27 (14%), 108 (54%), and 65 (33%) patients, respectively. During follow-up, 2 patients (annual event rate 0.6%) had cardiac death, none had nonfatal myocardial infarction, and 4 patients (annual event rate 1.1%) underwent a coronary revascularization procedure. All patients with cardiac events had high pretest probabilities of CAD. Patients with cardiac death (but unproven significant CAD) had maximal tests without angina or ischemic electrocardiographic changes. In contrast, all patients with subsequent coronary revascularization had dobutamine-induced angina or ischemic electrocardiographic changes, and all except one study were submaximal. We conclude tha...Continue Reading

References

Jun 14, 1979·The New England Journal of Medicine·G A Diamond, J S Forrester
Jul 1, 1990·American Heart Journal·S G SawadaW F Armstrong
Jul 1, 1985·Journal of the American College of Cardiology·F J WackersJ P Clements
Oct 15, 1994·The American Journal of Cardiology·M R HopfenspirgerR J Gibbons
Feb 1, 1996·Journal of the American College of Cardiology·A ElhendyP M Fioretti
Sep 1, 1997·Journal of the American College of Cardiology·M L GeleijnseJ R Roelandt

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Citations

Jun 22, 1999·Lancet·M L SimoonsJ W Deckers
May 2, 2003·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Robert FathiThomas H Marwick
Aug 24, 1999·Cardiology Clinics·D A Orsinelli, C J Daniels
Jun 3, 2004·Journal of the American College of Cardiology·Thomas H MarwickJames D Thomas
Sep 18, 2012·Journal of the American College of Cardiology·Harikrishna MakaniFarooq A Chaudhry
Apr 22, 2016·NPJ Primary Care Respiratory Medicine·Mark L LevySoren Pedersen

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