Abstract:
BACKGROUND:Recently revised American College of Cardiology/American Heart Association guidelines have suggested that exercise test scores be used in decisions concerning patients with suspected coronary artery disease (CAD). Pretest and exercise test scores derived for use in women without known CAD have not been tested in women with a low prevalence of CAD. METHODS:Within the Women's Ischemia Syndrome Evaluation (WISE) study, we evaluated 563 women undergoing coronary angiography for suspected myocardial ischemia. The prevalence of angiographic CAD was 26%. Overall, 189 women underwent treadmill exercise testing. Prognostic end points included death, myocardial infarction, stroke, and revascularization. RESULTS:Each score stratified women into 3 probability groups (P <.001) according to the prevalence of coronary disease: Pretest: low 20/164 (12%), intermediate 53/245 (22%), high 75/154 (49%); Exercise test: low 11/83 (13%), intermediate 22/74 (30%), high 17/32 (53%). However, the Duke score did not stratify as well: low 7/46 (15%), intermediate 36/126 (29%), high 6/17 (35%); P =.44. When pretest and exercise scores were considered together, the best stratification with the exercise test score was in the intermediate pretest group (P <.03). The Duke score did not stratify this group at all (P =.98). Pretest and exercise test scores also stratified women according to prognostic end points: pretest--low 7/164 (4.3%), intermediate 28/245 (11.4%), high 27/154 (17.5%), P <.01; exercise test--low 4/83 (4.8%) and intermediate-high 17/106 (16%), P =.014. CONCLUSION:Both pretest and exercise test scores performed better than the Duke score in stratifying women with a low prevalence of angiographic CAD. The exercise test score appears useful in women with an intermediate pretest score, consistent with American College of Cardiology/American Heart Association guidelines.
journal_name
Am Heart Jjournal_title
American heart journalauthors
Morise AP,Olson MB,Merz CN,Mankad S,Rogers WJ,Pepine CJ,Reis SE,Sharaf BL,Sopko G,Smith K,Pohost GM,Shaw Ldoi
10.1016/j.ahj.2003.12.034subject
Has Abstractpub_date
2004-06-01 00:00:00pages
1085-92issue
6eissn
0002-8703issn
1097-6744pii
S0002870304000560journal_volume
147pub_type
临床试验,杂志文章,多中心研究abstract::Detection of mild hypertension by a small number of casual blood pressures may be inaccurate for the determination of average blood pressure. Nonetheless, casual pressures remain the basis for the diagnosis and treatment of hypertensive patients. We compared casual and noninvasive ambulatory blood pressure monitoring ...
journal_title:American heart journal
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abstract:BACKGROUND:hypertrophic cardiomyopathy (HCM) is a major cause of sudden death in young athletes and one of the most common inherited cardiovascular diseases, affecting 1 in 500 individuals. Often viewed as a disease of the cardiac sarcomere, mutations in genes encoding myofilament proteins are associated with disease p...
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pub_type: 临床试验,杂志文章,随机对照试验
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pub_type: 临床试验,杂志文章
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pub_type: 临床试验,杂志文章
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