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Sicari, R. et al.

Sicari, Pasanisi, Venneri, Landi, Cortigiani, Picano,

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

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.[1]

References

Stress echo results predict mortality: a large-scale multicenter prospective international study. Sicari, R., Pasanisi, E., Venneri, L., Landi, P., Cortigiani, L., Picano, E. J. Am. Coll. Cardiol. (2003) [Pubmed]

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