Prognostic value of pharmacological stress echocardiography is affected by concomitant antiischemic therapy at the time of testing.

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

Circulation

journal_title

Circulation

authors

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.0000127427.03361.5E

subject

Has Abstract

pub_date

2004-05-25 00:00:00

pages

2428-31

issue

20

eissn

0009-7322

issn

1524-4539

pii

01.CIR.0000127427.03361.5E

journal_volume

109

pub_type

杂志文章,多中心研究
  • Short- versus long-term duration of dual-antiplatelet therapy after coronary stenting: a randomized multicenter trial.

    abstract:BACKGROUND:The optimal duration of dual-antiplatelet therapy and the risk-benefit ratio for long-term dual-antiplatelet therapy after coronary stenting remain poorly defined. We evaluated the impact of up to 6 versus 24 months of dual-antiplatelet therapy in a broad all-comers patient population receiving a balanced pr...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.111.071589

    authors: Valgimigli M,Campo G,Monti M,Vranckx P,Percoco G,Tumscitz C,Castriota F,Colombo F,Tebaldi M,Fucà G,Kubbajeh M,Cangiano E,Minarelli M,Scalone A,Cavazza C,Frangione A,Borghesi M,Marchesini J,Parrinello G,Ferrari R,P

    更新日期:2012-04-24 00:00:00

  • Oral everolimus inhibits in-stent neointimal growth.

    abstract:BACKGROUND:Rapamycin (sirolimus)-eluting stents are associated with reduced restenosis rates in animal studies and initial human trials. The present study evaluated whether orally administered everolimus (a macrolide of the same family as sirolimus) inhibits in-stent neointimal growth in rabbit iliac arteries. METHODS...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.0000033973.06059.04

    authors: Farb A,John M,Acampado E,Kolodgie FD,Prescott MF,Virmani R

    更新日期:2002-10-29 00:00:00

  • Magnetic resonance perfusion measurements for the noninvasive detection of coronary artery disease.

    abstract:BACKGROUND:With MRI, an index of myocardial perfusion reserve (MPRI) can be determined. We assessed the value of this technique for the noninvasive detection of coronary artery disease (CAD) in patients with suspected CAD. METHODS AND RESULTS:Eighty-four patients referred for a primary diagnostic coronary angiography ...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.CIR.0000080915.35024.A9

    authors: Nagel E,Klein C,Paetsch I,Hettwer S,Schnackenburg B,Wegscheider K,Fleck E

    更新日期:2003-07-29 00:00:00

  • Accurate volume determination in the isolated ejecting canine left ventricle by two-dimensional echocardiography.

    abstract::Two-dimensional echocardiography can provide serial cross-sectional images of the left ventricular cavity. We examined whether such serial images from steady-state ejecting hearts would allow three-dimensional reconstruction and accurate volume estimation without major geometric assumptions. Cross-circulated, paced do...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.60.2.320

    authors: Eaton LW,Maughan WL,Shoukas AA,Weiss JL

    更新日期:1979-08-01 00:00:00

  • Predictive value of noninvasive measures of atherosclerosis for incident myocardial infarction: the Rotterdam Study.

    abstract:BACKGROUND:Several noninvasive methods are available to investigate the severity of extracoronary atherosclerotic disease. No population-based study has yet examined whether differences exist between these measures with regard to their predictive value for myocardial infarction (MI) or whether a given measure of athero...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000120708.59903.1B

    authors: van der Meer IM,Bots ML,Hofman A,del Sol AI,van der Kuip DA,Witteman JC

    更新日期:2004-03-09 00:00:00

  • Elevated levels of C-reactive protein and interleukin-6 in patients with obstructive sleep apnea syndrome are decreased by nasal continuous positive airway pressure.

    abstract:BACKGROUND:C-reactive protein (CRP) and interleukin (IL)-6 are important risk factors for atherosclerosis and coronary heart disease. In the present study, we examined serum levels of CRP and IL-6, IL-6 production by monocytes, and the effect of nasal continuous positive airway pressure (nCPAP) in patients with obstruc...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.0000052627.99976.18

    authors: Yokoe T,Minoguchi K,Matsuo H,Oda N,Minoguchi H,Yoshino G,Hirano T,Adachi M

    更新日期:2003-03-04 00:00:00

  • Abnormal hormonal and renal responses to saline load in hypertensive patients with parental history of cardiovascular accidents.

    abstract:BACKGROUND:Acute cardiac and cerebrovascular accidents are more frequent in hypertensive subjects with a family history of acute vascular accidents. The mechanisms underlying the susceptibility to vascular disease in these subjects are unknown. We investigated whether a parental history of premature heart attack or str...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.84.1.92

    authors: Volpe M,Lembo G,De Luca N,Lamenza F,Tritto C,Ricciardelli B,Molaro M,De Campora P,Condorelli G,Rendina V

    更新日期:1991-07-01 00:00:00

  • Association between plasma levels of monocyte chemoattractant protein-1 and long-term clinical outcomes in patients with acute coronary syndromes.

    abstract:BACKGROUND:Monocyte chemoattractant protein-1 (MCP-1) is a chemokine responsible for the recruitment of monocytes to sites of inflammation. MCP-1 appears to play a critical role at multiple stages in atherosclerosis, including the initiation of the fatty streak, promotion of plaque instability, and remodeling after myo...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1161/01.cir.0000049742.68848.99

    authors: de Lemos JA,Morrow DA,Sabatine MS,Murphy SA,Gibson CM,Antman EM,McCabe CH,Cannon CP,Braunwald E

    更新日期:2003-02-11 00:00:00

  • Enhanced inflammatory response to coronary angioplasty in patients with severe unstable angina.

    abstract:BACKGROUND:Systemic markers of inflammation have been found in unstable angina. Disruption of culprit coronary stenoses may cause a greater inflammatory response in patients with unstable than those with stable angina. We assessed the time course of C-reactive protein (CRP), serum amyloid A protein (SAA), and interleuk...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.98.22.2370

    authors: Liuzzo G,Buffon A,Biasucci LM,Gallimore JR,Caligiuri G,Vitelli A,Altamura S,Ciliberto G,Rebuzzi AG,Crea F,Pepys MB,Maseri A

    更新日期:1998-12-01 00:00:00

  • Value of physical signs in the diagnosis of ventricular tachycardia.

    abstract:BACKGROUND:Although the use of physical signs for the diagnosis of ventricular tachycardia (VT) was described in the early 1900s, their value in this role has never been systematically assessed. METHODS AND RESULTS:Using a blinded, randomized protocol, we examined the ability of 26 clinicians to detect ventriculoatria...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.90.6.3103

    authors: Garratt CJ,Griffith MJ,Young G,Curzen N,Brecker S,Rickards AF,Camm AJ

    更新日期:1994-12-01 00:00:00

  • Measurement of cardioversion/defibrillation thresholds in man by a truncated exponential waveform and an apical patch-superior vena caval spring electrode configuration.

    abstract::Defibrillation/cardioversion thresholds were measured in 33 patients undergoing defibrillator implants. Each patient had a 12 cm2 patch placed near the left ventricular apex via a thoracotomy and a 10 cm2 spring lead placed pervenously at the right atrial-superior vena caval junction. Ventricular tachycardia of stable...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1161/01.cir.69.4.766

    authors: Winkle RA,Stinson EB,Bach SM Jr,Echt DS,Oyer P,Armstrong K

    更新日期:1984-04-01 00:00:00

  • Adiponectin specifically increased tissue inhibitor of metalloproteinase-1 through interleukin-10 expression in human macrophages.

    abstract:BACKGROUND:Vascular inflammation and subsequent matrix degradation play an important role in the development of atherosclerosis. We previously reported that adiponectin, an adipose-specific plasma protein, accumulated to the injured artery and attenuated vascular inflammatory response. Clinically, high plasma adiponect...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000127953.98131.ED

    authors: Kumada M,Kihara S,Ouchi N,Kobayashi H,Okamoto Y,Ohashi K,Maeda K,Nagaretani H,Kishida K,Maeda N,Nagasawa A,Funahashi T,Matsuzawa Y

    更新日期:2004-05-04 00:00:00

  • Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats.

    abstract:BACKGROUND:In this study we tested the hypothesis that atrial fibrillation (AF) causes electrophysiological changes of the atrial myocardium which might explain the progressive nature of the arrhythmia. METHODS AND RESULTS:Twelve goats were chronically instrumented with multiple electrodes sutured to the epicardium of...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.92.7.1954

    authors: Wijffels MC,Kirchhof CJ,Dorland R,Allessie MA

    更新日期:1995-10-01 00:00:00

  • Shed membrane microparticles with procoagulant potential in human atherosclerotic plaques: a role for apoptosis in plaque thrombogenicity.

    abstract:BACKGROUND:The specific role of apoptosis in human atherosclerosis remains unknown. During apoptotic cell death, phosphatidylserine exposure on the cell surface confers a high tissue-factor (TF)-dependent procoagulant activity. METHODS AND RESULTS:In this study, we examined the role of apoptotic cell death in the prom...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.99.3.348

    authors: Mallat Z,Hugel B,Ohan J,Lesèche G,Freyssinet JM,Tedgui A

    更新日期:1999-01-26 00:00:00

  • Validation of the Bleeding Academic Research Consortium definition of bleeding in patients with coronary artery disease undergoing percutaneous coronary intervention.

    abstract:BACKGROUND:The Bleeding Academic Research Consortium (BARC) has recently proposed a unified definition of bleeding in patients receiving antithrombotic therapy. We investigated the relationship between bleeding events as defined by BARC and 1-year mortality in patients undergoing percutaneous coronary intervention (PCI...

    journal_title:Circulation

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1161/CIRCULATIONAHA.111.060871

    authors: Ndrepepa G,Schuster T,Hadamitzky M,Byrne RA,Mehilli J,Neumann FJ,Richardt G,Schulz S,Laugwitz KL,Massberg S,Schömig A,Kastrati A

    更新日期:2012-03-20 00:00:00

  • Cardiac allograft ischemic time. Relation to graft survival and cardiac function.

    abstract::Organ donor scarcity has resulted in an increasing number of long-distance cardiac allograft procurements. The effect on short-term (90-day) survival and cardiac function was assessed in a consecutive series of 167 heart transplants performed between April 1981 and July 1988. During that time, total allograft ischemic...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:

    authors: Pflugfelder PW,Thomson D,Singh NR,Menkis AH,McKenzie FN,Kostuk WJ

    更新日期:1989-11-01 00:00:00

  • Tissue plasminogen activator and risk of myocardial infarction. The Rotterdam Study.

    abstract:BACKGROUND:Impaired fibrinolytic capacity, as assessed by euglobulin clot lysis time or plasma concentration of fibrinolytic parameters, has been associated with an increased risk of myocardial infarction (MI). We studied the association of a polymorphism in the gene for TPA and of plasma concentrations of TPA (antigen...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.95.12.2623

    authors: van der Bom JG,de Knijff P,Haverkate F,Bots ML,Meijer P,de Jong PT,Hofman A,Kluft C,Grobbee DE

    更新日期:1997-06-17 00:00:00

  • Modulation of atrioventricular nodal function by metabolic and allosteric regulators of endogenous adenosine in guinea pig heart.

    abstract:BACKGROUND:There has been increasing interest in the development of agents that utilize endogenous adenosine to exert their actions. We tested the hypothesis that substances that either potentiate the activity (allosteric enhancers) or increase the interstitial concentration (inhibitors of metabolism) of endogenous ade...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.94.10.2551

    authors: Dennis DM,Raatikainen MJ,Martens JR,Belardinelli L

    更新日期:1996-11-15 00:00:00

  • Coronary arterial spasm and Prinzmetal's variant form of angina induced by hyperventilation and Tris-buffer infusion.

    abstract::Vigorous hyperventilation was induced for five minutes immediately after a five-minute infusion of 100 ml of Tris-buffer (pH 10) in nine patients with Prinzmetal's variant angina. In eight of the patients, chest pain with ischemic changes in the electrocardiogram occurred during this procedure or within five minutes a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.58.1.56

    authors: Yasue H,Nagao M,Omote S,Takizawa A,Miwa K,Tanaka S

    更新日期:1978-07-01 00:00:00

  • Noninvasive quantitation of valvular regurgitation by gated equilibrium radionuclide angiography.

    abstract::R-wave synchronous equilbrium radionuclide angiography (RNA) is a noninvasive method that provides time-activity curve count information proportional to ventricular volumes and is used for relative volume comparisons within the left or right ventricle to derive the ejection fraction. Comparison of the ventricular coun...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.62.5.1089

    authors: Sorensen SG,O'Rourke RA,Chaudhuri TK

    更新日期:1980-11-01 00:00:00

  • Sodium, blood pressure, and cardiovascular disease: further evidence supporting the American Heart Association sodium reduction recommendations.

    abstract::Recent reports of selected observational studies and a meta-analysis have stirred controversy and have become the impetus for calls to abandon recommendations for reduced sodium intake by the US general population. A detailed review of these studies documents substantial methodological concerns that limit the usefulne...

    journal_title:Circulation

    pub_type: 共识发展会议,杂志文章

    doi:10.1161/CIR.0b013e318279acbf

    authors: Whelton PK,Appel LJ,Sacco RL,Anderson CA,Antman EM,Campbell N,Dunbar SB,Frohlich ED,Hall JE,Jessup M,Labarthe DR,MacGregor GA,Sacks FM,Stamler J,Vafiadis DK,Van Horn LV

    更新日期:2012-12-11 00:00:00

  • Different contributions of endothelin-A and endothelin-B receptors in postischemic cardiac dysfunction and norepinephrine overflow in rat hearts.

    abstract:BACKGROUND:Endothelin (ET)-1 and norepinephrine (NE) are involved in myocardial ischemia/reperfusion injury. We investigated the role of ET-1 in ischemia/reperfusion-induced NE overflow and cardiac dysfunction using a selective ET(A) receptor antagonist (ABT-627), a selective ET(B) receptor antagonist (A-192621), and t...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.CIR.0000153351.86708.F7

    authors: Yamamoto S,Matsumoto N,Kanazawa M,Fujita M,Takaoka M,Gariepy CE,Yanagisawa M,Matsumura Y

    更新日期:2005-01-25 00:00:00

  • Effect of continuous positive airway pressure on intrathoracic and left ventricular transmural pressures in patients with congestive heart failure.

    abstract:BACKGROUND:Continuous positive airway pressure (CPAP) can improve cardiac function in patients with congestive heart failure (CHF). We hypothesized that this effect might be related to CPAP-induced increases in intrathoracic pressure, which would reduce left ventricular transmural pressure (LVPtm) during systole, there...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.cir.91.6.1725

    authors: Naughton MT,Rahman MA,Hara K,Floras JS,Bradley TD

    更新日期:1995-03-15 00:00:00

  • Human monocyte-endothelial cell interaction induces synthesis of granulocyte-macrophage colony-stimulating factor.

    abstract:BACKGROUND:Adhesion of monocytes to the endothelium is an initial step in the early stages of atherosclerosis and inflammation. Granulocyte-macrophage colony-stimulating factor (GM-CSF) stimulates a range of functional activities of monocytes, including regulation of monocyte adhesion and induction of cytokine producti...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.93.6.1185

    authors: Takahashi M,Kitagawa S,Masuyama JI,Ikeda U,Kasahara T,Takahashi YI,Furukawa Y,Kano S,Shimada K

    更新日期:1996-03-15 00:00:00

  • Frame count reserve.

    abstract:BACKGROUND:The Doppler wire-derived (relative) coronary flow velocity reserve (CVR) that is used to evaluate functional significance of a coronary stenosis is a method performed only by interventional cardiologists. An angiographic method would be useful in the diagnostic catheterization laboratory. For this purpose, w...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:10.1161/01.CIR.0000074279.44131.DE

    authors: Stoel MG,Zijlstra F,Visser CA

    更新日期:2003-06-24 00:00:00

  • Coronary atherosclerosis. A multifactorial disease.

    abstract:BACKGROUND:Several of the theories on the pathogenesis of atherosclerosis may be integrated into a single multifactorial one. According to this theory, the most likely sequence of events involved in early atherosclerosis is vascular dysfunction and/or injury, monocyte recruitment and macrophage formation, lipid deposit...

    journal_title:Circulation

    pub_type: 杂志文章,评审

    doi:

    authors: Badimon JJ,Fuster V,Chesebro JH,Badimon L

    更新日期:1993-03-01 00:00:00

  • The association between urinary sodium excretion and blood pressure in children.

    abstract::This study explored the association between sodium excretion and blood pressure (BP). A new method was used to minimize the measurement error introduced by the large intrinsic variability of 24-hour sodium excretion. The ratio of intra- to interindividual variation was used to estimate the number of measurements neede...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.62.1.97

    authors: Cooper R,Soltero I,Liu K,Berkson D,Levinson S,Stamler J

    更新日期:1980-07-01 00:00:00

  • Effect of aging on cerebral autoregulation during cardiopulmonary bypass. Association with postoperative cognitive dysfunction.

    abstract:BACKGROUND:Age is a predictor of cognitive dysfunction after cardiac surgery, but the mechanism is unknown. The purpose of our study was to determine whether age-related decrements in cognition are associated with cerebral blood flow (CBF) autoregulation during cardiopulmonary bypass (CPB). METHODS AND RESULTS:Cogniti...

    journal_title:Circulation

    pub_type: 临床试验,杂志文章

    doi:

    authors: Newman MF,Croughwell ND,Blumenthal JA,White WD,Lewis JB,Smith LR,Frasco P,Towner EA,Schell RM,Hurwitz BJ

    更新日期:1994-11-01 00:00:00

  • The Safety and Efficacy of Aspirin Discontinuation on a Background of a P2Y12 Inhibitor in Patients After Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis.

    abstract:BACKGROUND:Dual antiplatelet therapy with aspirin and a P2Y12 inhibitor has been shown to reduce the risk of major adverse cardiovascular events (MACE) compared with aspirin alone after percutaneous coronary intervention (PCI) or acute coronary syndrome but with increased risk of bleeding. The safety of discontinuing a...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/CIRCULATIONAHA.120.046251

    authors: O'Donoghue ML,Murphy SA,Sabatine MS

    更新日期:2020-08-11 00:00:00

  • Vasodilatation to arachidonic acid in humans. An insight into endogenous prostanoids and effects of aspirin.

    abstract:BACKGROUND:Human endothelial and vascular smooth muscle cells synthesize prostanoids. Several of these have been implicated in the physiological and pathophysiological regulation of vascular tone; however, there is no direct evidence that human blood vessels synthesize sufficient prostanoid to alter vessel tone. METHO...

    journal_title:Circulation

    pub_type: 杂志文章

    doi:10.1161/01.cir.92.8.2113

    authors: Bhagat K,Collier J,Vallance P

    更新日期:1995-10-15 00:00:00