Abstract
Background. Rational prognostic algorithm should be developed considering the logical progression of the information as it becomes available to the physician, with clinical data first, ECG data second and stress imaging data last. The aim of the present study was to assess in a clinically realistic fashion the relative prognostic value of exercise electrocardiography test (EET) and dipyridamole-echocardiography test (DET) early after first acute uncomplicated myocardial infarction. Methods and results. Five hundred and forty-seven in-hospital patients (age = 56 ± 9 years) with recent clinically uncomplicated first myocardial infarction, baseline echocardiographic findings of satisfactory quality, interpretable ECG and capability to exercise underwent a resting 2D echocardiogram, a DET and an EET at a mean of 10 days from the infarction and were followed up for 16.2 ± 11 months. During the follow-up, there were 17 cardiac deaths, 19 non-fatal myocardial infarctions and 49 unstable angina. When cardiac death was considered as the only significant event, with multivariate analysis, peak dipyridamole Wall Motion Score Index was the only significant predictor (χ2 = 5.66; p = 0.013; relative risk estimate = 4.7; confidence intervals = 1.35-16.08). In presence of a negative exercise electrocardiography test for both chest pain and electrocardiographic criteria, the death rate was 2%. Conclusion. DET provides stronger information in comparison with historical and EET variables. However, a negative maximal EET is sufficient to identify a very low risk subset in whom additional testing may not be warranted.
| Original language | English |
|---|---|
| Pages (from-to) | 32-39 |
| Number of pages | 8 |
| Journal | Giornale Italiano di Cardiologia |
| Volume | 27 |
| Issue number | 1 |
| Publication status | Published - Jan 1997 |
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Keywords
- dipyridamole
- exercise
- infarction
- prognosis
- stress echocardiography
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
The relative value of exercise-electrocardiography and dipyridamole stress echocardiography for risk stratification early after uncomplicated myocardial infarction. / Picano, Eugenio; Sicari, Rosa; Baroni, Monica; Del Negro, Blanca; Michelassi, Claudio; Pirelli, Salvatore; Chiarandà, Giacomo; Previtali, Mario; Seveso, Giovanni; Gandolfo, Nicola; Vassalle, Cristina; Margaria, Franca; Magaia, Ornella; Bianchi, Federico; Minardi, Giovanni; Landi, Patrizia; Raciti, Mauro; Severi, Silva.
In: Giornale Italiano di Cardiologia, Vol. 27, No. 1, 01.1997, p. 32-39.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The relative value of exercise-electrocardiography and dipyridamole stress echocardiography for risk stratification early after uncomplicated myocardial infarction
AU - Picano, Eugenio
AU - Sicari, Rosa
AU - Baroni, Monica
AU - Del Negro, Blanca
AU - Michelassi, Claudio
AU - Pirelli, Salvatore
AU - Chiarandà, Giacomo
AU - Previtali, Mario
AU - Seveso, Giovanni
AU - Gandolfo, Nicola
AU - Vassalle, Cristina
AU - Margaria, Franca
AU - Magaia, Ornella
AU - Bianchi, Federico
AU - Minardi, Giovanni
AU - Landi, Patrizia
AU - Raciti, Mauro
AU - Severi, Silva
PY - 1997/1
Y1 - 1997/1
N2 - Background. Rational prognostic algorithm should be developed considering the logical progression of the information as it becomes available to the physician, with clinical data first, ECG data second and stress imaging data last. The aim of the present study was to assess in a clinically realistic fashion the relative prognostic value of exercise electrocardiography test (EET) and dipyridamole-echocardiography test (DET) early after first acute uncomplicated myocardial infarction. Methods and results. Five hundred and forty-seven in-hospital patients (age = 56 ± 9 years) with recent clinically uncomplicated first myocardial infarction, baseline echocardiographic findings of satisfactory quality, interpretable ECG and capability to exercise underwent a resting 2D echocardiogram, a DET and an EET at a mean of 10 days from the infarction and were followed up for 16.2 ± 11 months. During the follow-up, there were 17 cardiac deaths, 19 non-fatal myocardial infarctions and 49 unstable angina. When cardiac death was considered as the only significant event, with multivariate analysis, peak dipyridamole Wall Motion Score Index was the only significant predictor (χ2 = 5.66; p = 0.013; relative risk estimate = 4.7; confidence intervals = 1.35-16.08). In presence of a negative exercise electrocardiography test for both chest pain and electrocardiographic criteria, the death rate was 2%. Conclusion. DET provides stronger information in comparison with historical and EET variables. However, a negative maximal EET is sufficient to identify a very low risk subset in whom additional testing may not be warranted.
AB - Background. Rational prognostic algorithm should be developed considering the logical progression of the information as it becomes available to the physician, with clinical data first, ECG data second and stress imaging data last. The aim of the present study was to assess in a clinically realistic fashion the relative prognostic value of exercise electrocardiography test (EET) and dipyridamole-echocardiography test (DET) early after first acute uncomplicated myocardial infarction. Methods and results. Five hundred and forty-seven in-hospital patients (age = 56 ± 9 years) with recent clinically uncomplicated first myocardial infarction, baseline echocardiographic findings of satisfactory quality, interpretable ECG and capability to exercise underwent a resting 2D echocardiogram, a DET and an EET at a mean of 10 days from the infarction and were followed up for 16.2 ± 11 months. During the follow-up, there were 17 cardiac deaths, 19 non-fatal myocardial infarctions and 49 unstable angina. When cardiac death was considered as the only significant event, with multivariate analysis, peak dipyridamole Wall Motion Score Index was the only significant predictor (χ2 = 5.66; p = 0.013; relative risk estimate = 4.7; confidence intervals = 1.35-16.08). In presence of a negative exercise electrocardiography test for both chest pain and electrocardiographic criteria, the death rate was 2%. Conclusion. DET provides stronger information in comparison with historical and EET variables. However, a negative maximal EET is sufficient to identify a very low risk subset in whom additional testing may not be warranted.
KW - dipyridamole
KW - exercise
KW - infarction
KW - prognosis
KW - stress echocardiography
UR - http://www.scopus.com/inward/record.url?scp=8244224547&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=8244224547&partnerID=8YFLogxK
M3 - Article
C2 - 9199941
AN - SCOPUS:8244224547
VL - 27
SP - 32
EP - 39
JO - Giornale Italiano di Cardiologia
JF - Giornale Italiano di Cardiologia
SN - 0046-5968
IS - 1
ER -