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.
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.
Authors: Eugenio Picano; Quirino Ciampi; Rodolfo Citro; Antonello D'Andrea; Maria Chiara Scali; Lauro Cortigiani; Iacopo Olivotto; Fabio Mori; Maurizio Galderisi; Marco Fabio Costantino; Lorenza Pratali; Giovanni Di Salvo; Eduardo Bossone; Francesco Ferrara; Luna Gargani; Fausto Rigo; Nicola Gaibazzi; Giuseppe Limongelli; Giuseppe Pacileo; Maria Grazia Andreassi; Bruno Pinamonti; Laura Massa; Marco A R Torres; Marcelo H Miglioranza; Clarissa Borguezan Daros; José Luis de Castro E Silva Pretto; Branko Beleslin; Ana Djordjevic-Dikic; Albert Varga; Attila Palinkas; Gergely Agoston; Dario Gregori; Paolo Trambaiolo; Sergio Severino; Ayana Arystan; Marco Paterni; Clara Carpeggiani; Paolo Colonna Journal: Cardiovasc Ultrasound Date: 2017-01-18 Impact factor: 2.062
Authors: Jamie M O'Driscoll; Paula Gargallo-Fernandez; Marco Araco; Manuel Perez-Lopez; Rajan Sharma Journal: Int J Cardiovasc Imaging Date: 2017-07-06 Impact factor: 2.357
Authors: Andrea Baggiano; Gianpiero Italiano; Marco Guglielmo; Laura Fusini; Andrea Igoren Guaricci; Riccardo Maragna; Carlo Maria Giacari; Saima Mushtaq; Edoardo Conte; Andrea Daniele Annoni; Alberto Formenti; Maria Elisabetta Mancini; Daniele Andreini; Mark Rabbat; Mauro Pepi; Gianluca Pontone Journal: J Clin Med Date: 2022-01-18 Impact factor: 4.241