Prognostic value of dobutamine stress echocardiography in patients with previous coronary revascularisation
OBJECTIVE: To assess the prognostic value of dobutamine stress echocardiography (DSE) in patients with previous myocardial revascularisation. DESIGN: Prospective study. SETTING: Tertiary referral centre in Rotterdam, the Netherlands. PATIENTS: 332 consecutive patients with previous percutaneous or surgical coronary revascularisation underwent DSE. Follow up was successful for 331 (99.7%) patients. Thirty eight patients who underwent early revascularisation (<or= 3 months) after the test were excluded from analysis. MAIN OUTCOME MEASURES: Cox proportional hazards regression models were used to identify independent predictors of the composite of cardiac events (cardiac death, non-fatal myocardial infarction, and late revascularisation). RESULTS: During a mean (SD) of 24 (20) months, 37 (13%) patients died and 89 (30%) had at least one cardiac event (21 (7%) cardiac deaths, 11 (4%) non-fatal myocardial infarctions, and 68 (23%) late revascularisations). In multivariate analysis of clinical data, independent predictors of late cardiac events were hypertension (hazard ratio (HR) 1.7, 95% confidence interval (CI) 1.1 to 2.6) and congestive heart failure (HR 2.1, 95% CI 1.3 to 3.2). Reversible wall motion abnormalities (ischaemia) on DSE were incrementally predictive of cardiac events (HR 2.1, 95% CI 1.3 to 3.2). CONCLUSIONS: Myocardial ischaemia during DSE is independently predictive of cardiac events among patients with previous myocardial revascularisation, after controlling for clinical data.
|Keywords||Echocardiography, Stress/*mortality, Female, Follow-Up Studies, Heart Failure, Congestive/etiology/mortality, Humans, Hypertension/etiology/mortality, Male, Middle Aged, Multivariate Analysis, Myocardial Ischemia/*diagnosis/mortality, Myocardial Revascularization/*mortality, Predictive Value of Tests, Prognosis, Prospective Studies, Risk Factors, Survival Rate|
Bountioukos, M., Elhendy, A., Schinkel, A.F., Bax, J.J., Krenning, B.J., Biagini, E., … van Domburg, R.T.. (2004). Prognostic value of dobutamine stress echocardiography in patients with previous coronary revascularisation. Heart, 90(9), 1031–1035. Retrieved from http://hdl.handle.net/1765/8323