European Heart Journal Advance Access originally published online on July 13, 2005
European Heart Journal 2005 26(20):2136-2141; doi:10.1093/eurheartj/ehi408
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Long-term survival of patients with chest pain syndrome and angiographically normal or near-normal coronary arteries: the additional prognostic value of dipyridamole echocardiography test (DET)
1CNR, Institute of Clinical Physiology, Via G. Moruzzi 1, 56123 Pisa, Italy
2Internal Medicine Department, Elisabeth Hospital, Hódmezõvásárhely, Hungary
Received 4 January 2005; revised 28 April 2005; accepted 16 June 2005; online publish-ahead-of-print 13 July 2005.
* Corresponding author. Tel: +39 050 315237; fax: +39 050 31522374. E-mail address: rosas{at}ifc.cnr.it
See page 2077 for the editorial comment on this article (doi:10.1093/eurheartj/ehi476)
Aims Patients with normal coronary arteries have a heterogeneous prognosis. Aim of this study was to assess whether dipyridamole stress echocardiography positivity identifies a prognostically less benign subset.
Methods and results We selected 457 patients (245 males; 56±10 years) who underwent stress high-dose dipyridamole echocardiography and had angiographically non-significant (<50% visually assessed) stenosis in any major vessel and preserved left ventricular function. All patients were followed up for a median of 7.1 years (first quartile 5 and third quartile 10.5). Dipyridamole echocardiography test (DET) positivity for regional dysfunction occurred in 43(9%) patients. Kaplan–Meier survival estimates showed a significant better outcome for those patients with negative dipyridamole echocardiography test compared with those with a positive test (90 vs. 75.7%, at 140 months of follow-up, P=0.0018). At multivariable analysis, mild or moderate irregularity on coronary arteriogram (HR=3.3, CI 95%=1.7–6.2), diabetes (HR=3.5, CI 95%=1.4–9.2), and wall motion score index at peak stress (HR=6.7, CI 95%=2.5–17.8) were independent predictors of all-cause death.
Conclusion DET adds incremental value to the prognostic stratification achieved with clinical and angiographic data in the subset of patients with normal or near-normal coronary arteries.
Key Words: Dipyridamole echocardio-graphy test (DET) • Prognosis • Normal coronary artery
CiteULike 
Connotea 
Del.icio.us What's this?
Related articles in EHJ:
- Ischaemia and outcome with normal coronary arteries
- Thomas H. Marwick
EHJ 2005 26: 2077-2078.[Extract] [FREE Full Text]
This article has been cited by other articles:
|
|
 |
|
  R. Sicari, P. Nihoyannopoulos, A. Evangelista, J. Kasprzak, P. Lancellotti, D. Poldermans, J.-U. Voigt, J. L. Zamorano, and on behalf of the European Association of Echocardi Stress echocardiography expert consensus statement: European Association of Echocardiography (EAE) (a registered branch of the ESC) Eur J Echocardiogr, July 1, 2008; 9(4): 415 - 437. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. D. Johnson, L. J. Shaw, C. J. Pepine, S. E. Reis, S. F. Kelsey, G. Sopko, W. J. Rogers, S. Mankad, B. L. Sharaf, V. Bittner, et al. Persistent chest pain predicts cardiovascular events in women without obstructive coronary artery disease: results from the NIH-NHLBI-sponsored Women's Ischaemia Syndrome Evaluation (WISE) study Eur. Heart J., June 2, 2006; 27(12): 1408 - 1415. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Martinez-Selles, T. Datino, and A. Pello Dipyridamole echocardiography test in patients with normal or near normal coronary arteries Eur. Heart J., February 2, 2006; 27(4): 499 - 499. [Full Text] [PDF]
|
|
|
|
|
|
T. H. Marwick Ischaemia and outcome with normal coronary arteries Eur. Heart J., October 2, 2005; 26(20): 2077 - 2078. [Full Text] [PDF]
|
|