Abstract:
BACKGROUND:The aim of this study was to determine whether antianginal medications affect the prognostic value of pharmacological stress echocardiography. METHODS AND RESULTS:From the EPIC-EDIC Data Bank, 7333 patients (5452 men; age; 59+/-10 years) underwent pharmacological stress echocardiography with either high-dose dipyridamole (0.84 mg/kg over 10 minutes; n=4984) or high-dose dobutamine (up to 40 microg x kg(-1) x min(-1); n=2349) (DET) for diagnostic purposes. At the time of testing, 1791 patients were on antiischemic therapy (nitrates and/or calcium antagonists and/or beta-blockers). Patients were followed up for a mean of 2.6 years (range, 1 to 206 months). DET was positive for myocardial ischemia in 2854 patients (39%) and negative in 4479 (61%). Total mortality was 336 (4.5%). Death was attributed to cardiac causes in 161 patients (2.1%). Survival was highest in patients with negative DET off therapy and lowest in patients with positive DET studied on therapy (95% versus 81%; P=0.0000). Survival was comparable in patients with a negative test on therapy and in patients with a positive test off therapy (88% versus 84%, P=NS). CONCLUSIONS:Ongoing antiischemic therapy at the time of testing heavily modulates the prognostic value of pharmacological stress echo. In the presence of concomitant antiischemic therapy, a positive test is more prognostically malignant, and a negative test less prognostically benign.
journal_name
Circulationjournal_title
Circulationauthors
Sicari R,Cortigiani L,Bigi R,Landi P,Raciti M,Picano E,Echo-Persantine International Cooperative (EPIC) Study Group.,Echo-Dobutamine International Cooperative (EDIC) Study Group.doi
10.1161/01.CIR.0000127427.03361.5Esubject
Has Abstractpub_date
2004-05-25 00:00:00pages
2428-31issue
20eissn
0009-7322issn
1524-4539pii
01.CIR.0000127427.03361.5Ejournal_volume
109pub_type
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