Abstract | OBJECTIVES: This study sought to assess the long-term prognostic utility of dobutamine stress echocardiography in predicting fatal and nonfatal cardiac events. BACKGROUND: METHODS: All patients presenting for coronary angiography for chest pain were eligible for recruitment. Follow-up was 100% complete at 5 years (range 3.0 to 6.1). Cardiac events were defined as cardiac death or nonfatal myocardial infarction or the need for coronary revascularization (coronary angioplasty or bypass surgery). RESULTS: Positive (n = 78) and negative (n = 42) dobutamine test groups differed in their rates of coronary artery bypass graft surgery (37.2% vs. 9.5%, p < 0.001, respectively) and mortality. Of 26 total deaths, 22 occurred in the group with positive dobutamine test results (28% vs. 9.5%, p < 0.018); all 7 cardiac deaths occurred in this group as well (9% vs. 0%, p < 0.045). By multivariate regression analysis, positive results on dobutamine echocardiography remained independently predictive of future cardiac death after left ventricular ejection fraction and other clinical variables were accounted for. CONCLUSIONS: A positive finding on dobutamine echocardiography is an independent predictor of long-term cardiac mortality, whereas a negative finding confers a significantly reduced likelihood of cardiac death as much as 5 years from initial testing. We conclude that dobutamine stress echocardiography can be used to predict which patients with suspected coronary artery disease are at low risk for cardiac death and do not require concurrent nuclear or invasive testing.
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Authors | E H Steinberg, L Madmon, C P Patel, S P Sedlis, I Kronzon, J L Cohen |
Journal | Journal of the American College of Cardiology
(J Am Coll Cardiol)
Vol. 29
Issue 5
Pg. 969-73
(Apr 1997)
ISSN: 0735-1097 [Print] United States |
PMID | 9120183
(Publication Type: Journal Article)
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Chemical References |
- Cardiotonic Agents
- Dobutamine
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Topics |
- Aged
- Angioplasty, Balloon, Coronary
- Cardiac Catheterization
- Cardiotonic Agents
- Coronary Angiography
- Coronary Artery Bypass
- Coronary Disease
(diagnostic imaging, mortality, therapy)
- Dobutamine
- Echocardiography
- Female
- Follow-Up Studies
- Humans
- Male
- Predictive Value of Tests
- Prognosis
- Prospective Studies
- Survival Analysis
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