Skip Navigation

European Heart Journal 1995 16(Supplement M):3-10; doi:10.1093/eurheartj/16.suppl_M.3
Copyright © 1995 by the European Society of Cardiology.
This Article
Right arrow Full Text (PDF)
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Geleijnse, M. L.
Right arrow Articles by Fioretti, P. M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Geleijnse, M. L.
Right arrow Articles by Fioretti, P. M.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 1995 The European Society of Cardiology

Optimal pharmacological stress testing for the diagnosis of coronary artery disease: a probabilistic approach

M. L. Geleijnse*, T. H. Marwick{dagger},{ddagger}, E. Boersma*, J. W. Deckers*, J. A. Melin{dagger} and P. M. Fioretti*

* Thoraxcenter and The Department of Nuclear Medicine, University Hospital Dijkzigt and Erasmus University Rotterdam The Netherlands
{dagger} Divisions of Cardiology and Nuclear Medicine, Cliniques Universitaires St. Luc, University of Louvain Brussels, Belgium

Previous reports have suggested that dobutamine stress echocardiography compares favourably with other stress agent-imaging modality combinations for the detection of coronary artery disease. However, in daily clinical practice the value of a test is defined on a probability basis. To study the relative diagnostic contribution of clinical and dobutamine stress test variables, Bayesian analysis was performed in 223 patients with suspected coronary artery disease, who underwent coronary angiography and a high-dose dobutamine stress test in conjunction with electrocar-diography, echocardiography and Technetium-99m sestamibi SPECT myocardial perfusion scintigraphy. According to the pre-test (clinical) probabilities, patients were divided into low-, intermediate- and high-risk groups; 155 patients were in the intermediate-risk group. After dobutamine stress echocardiography the number of patients in this intermediate-risk group was reduced to 102 (P<0.0001). This reduction of patients in the intermediate-risk group by echocardiography was better than perfusion scintigraphy (102 vs 126 patients, P<0.05) or classic markers of ischaemia such as angina and/or ST-segment changes (102 vs 150, P<0.0001). Moreover, there was a good correlation between the echocardiographic post-test probabilities and the true distribution of coronary artery disease.

Key Words: Coronary artery disease • pharmacological stress • diagnostic value • probabilistic approach

{ddagger} Present address: Cardiology Department, Cleveland Clinical Foundation, Cleveland, Ohio, U.S.A.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?




Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.