Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
Using an outcomes-based approach to identify candidates for risk stratification after exercise treadmill testing
Autore:
Shaw, LJ; Hachamovitch, R; Peterson, ED; Lewin, HC; Iskandrian, AE; Miller, DD; Berman, DS;
Indirizzi:
Emory Ctr Outcomes Res, Div Cardiol, Atlanta, GA 30322 USA Emory Ctr Outcomes Res Atlanta GA USA 30322 ardiol, Atlanta, GA 30322 USA
Titolo Testata:
JOURNAL OF GENERAL INTERNAL MEDICINE
fascicolo: 1, volume: 14, anno: 1999,
pagine: 1 - 9
SICI:
0884-8734(199901)14:1<1:UAOATI>2.0.ZU;2-0
Fonte:
ISI
Lingua:
ENG
Soggetto:
CORONARY-ARTERY DISEASE; ISCHEMIC-HEART-DISEASE; PREDICT TRIPLE-VESSEL; PROGNOSTIC VALUE; MYOCARDIAL ISCHEMIA; SCORE; ELECTROCARDIOGRAM; SENSITIVITY; INFARCTION; LIKELIHOOD;
Keywords:
exercise testing; prognosis; coronary artery disease;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
26
Recensione:
Indirizzi per estratti:
Indirizzo: Shaw, LJ EmoryGAtr Outcomes Res, Div Cardiol, Room 638,1518 Clifton Rd NE,Atlanta, Emory Ctr Outcomes Res Room 638,1518 Clifton Rd NE Atlanta GA USA30322
Citazione:
L.J. Shaw et al., "Using an outcomes-based approach to identify candidates for risk stratification after exercise treadmill testing", J GEN INT M, 14(1), 1999, pp. 1-9

Abstract

OBJECTIVE:To develop a hierarchical approach to cardiac risk stratification after treadmill testing. PATIENTS: Clinical and treadmill test data were used to identify a patientpopulation that may be candidates for further risk stratification with stress tomographic myocardial perfusion imaging. A prospective series of 3,620medically treated patients (42% female, mean age 63 years) with a 2.5% mortality was identified (follow-up 2.5 +/- SD 1.5 years). MEASUREMENTS AND MAIN RESULTS: A Cox proportional :hazards model was used to estimate a patient's likelihood of cardiac death. Kaplan-Meier survival curves were used to estimate time to cardiac death by nuclear test results. Annual rates of cardiac death were 0.4% (n = 921), 1% (n = 2,498), and 1% (n = 201) for patients with lear, intermediate, and high Duke treadmill scores (DTS). For patients with an intermediate DTS, multivariate estimators of cardiac death included the number of ischemic vascular territories (relative risk per defect 1.4, p =.01), the number of infarcted vascular territories (relative risk per defect 2.4, p =.00001), and the DTS (relative risk per unit 0.97, p =.00001), following adjustment for a patient's pretest riskof coronary disease. For patients with an intermediate DTS, the presence of no, one or two, and three vascular territories with defects was associated with annual rates of cardiac death of 0.5%, 1.4%, and 2.5%, respectively (p < .0001), Kaplan-Meier survival curves exhibited a statistically worsening survival for patients with defects by 1 year after treadmill exercise. CONCLUSIONS: For symptomatic patients with an intermediate treadmill test score, the exercise myocardial perfusion scan may be used to stratify theirrisk of cardiac death over 3 yl:ars of follow-up. Patient management may be efficiently guided by further outcome assessment, with an exercise nuclear scan for patients whose treadmill test score is intermediate.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 07/04/20 alle ore 23:05:45