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J Am Coll Cardiol. 2003 Feb 19;41(4):589-95.

Stress echo results predict mortality: a large-scale multicenter prospective international study.

Author information

1
National Council of Research, Institute of Clinical Physiology, Via G. Moruzzi 1, 56125 Pisa, Italy. rosas@ifc.cnr.it

Abstract

OBJECTIVES:

The purpose of this study was to assess the long-term value of pharmacologic stress echocardiography with either dipyridamole or dobutamine (DET) for prediction of cardiac death in patients with proven or suspected coronary artery disease (CAD).

BACKGROUND:

Stress echocardiography is an established, cost-effective technique for the detection of CAD.

METHODS:

From the Echo Persantine International Cooperative-Echo Dobutamine International Cooperative data bank, 7,333 patients (5,452 males; 59 +/- 10 years) underwent pharmacologic stress echocardiography with either high-dose dipyridamole (0.84 mg/kg over 10 min) (n = 4,984) or high-dose dobutamine (up to 40 microg/kg/3 min) (n = 2,349) for diagnostic purposes. Patients were followed up for a mean of 2.6 years (range 1 to 206 months).

RESULTS:

The DET was positive for myocardial ischemia in 2,854 (35%) patients and negative in 4,479 (61%) patients. During the follow-up there were 161 cardiac deaths (sudden death and fatal myocardial infarction) (2.1% of the total population). Kaplan-Meier survival estimates showed a significantly better outcome for those patients with a negative pharmacologic stress echocardiography test compared with those with a positive test (92 vs. 71.2%, p = 0.0000).

CONCLUSIONS:

Pharmacologic stress echocardiography with either dipyridamole or dobutamine is effective in predicting cardiac death during a long-term follow-up. A negative stress echocardiography test result is related to a favorable outcome.

PMID:
12598070
DOI:
10.1016/s0735-1097(02)02863-2
[Indexed for MEDLINE]
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