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Titolo:
Perioperative prognostic value of dipyridamole echocardiography in vascular surgery - A large-scale multicenter study in 509 patients
Autore:
Sicari, R; Ripoli, A; Picano, E; Djordjevic-Dikic, A; Di Giovanbattista, R; Minardi, G; Matskeplishvili, S; Ambatiello, S; Pulignano, G; Accarino, M; Lusa, AM; Del Rosso, GF; Pedrinelli, R; Buziashvili, Y;
Indirizzi:
CNR, Inst Clin Physiol, I-56100 Pisa, Italy CNR Pisa Italy I-56100CNR, Inst Clin Physiol, I-56100 Pisa, Italy
Titolo Testata:
CIRCULATION
fascicolo: 19, volume: 100, anno: 1999, supplemento:, S
pagine: 269 - 274
SICI:
0009-7322(19991109)100:19<269:PPVODE>2.0.ZU;2-E
Fonte:
ISI
Lingua:
ENG
Soggetto:
DOBUTAMINE STRESS ECHOCARDIOGRAPHY; MAJOR CARDIAC EVENTS; RISK STRATIFICATION; MYOCARDIAL-INFARCTION; PREDICTIVE VALUE; AORTIC-SURGERY; THALLIUM SCINTIGRAPHY; NONCARDIAC SURGERY; DISEASE; DIPYRIDAMOLE-THALLIUM-201;
Keywords:
echocardiography; trials; stress; risk factors; surgery;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
34
Recensione:
Indirizzi per estratti:
Indirizzo: Sicari, R CNR, Inst Clin Physiol, Via Savi 8, I-56100 Pisa, Italy CNR Via Savi 8 Pisa Italy I-56100 a Savi 8, I-56100 Pisa, Italy
Citazione:
R. Sicari et al., "Perioperative prognostic value of dipyridamole echocardiography in vascular surgery - A large-scale multicenter study in 509 patients", CIRCULATION, 100(19), 1999, pp. 269-274

Abstract

Background-Patients undergoing major Vascular surgery are at a relatively high risk of cardiac events, and pharmacological stress echocardiography isincreasingly used for perioperative risk stratification. The aim of the current study was to evaluate the value of dipyridamole echocardiography test(up to 0.84 mg/kg over 10 minutes) in predicting cardiac events in a large-scale, multicenter, prospective, observational study design. Methods and Results-Five hundred nine patients (mean age 66+/-10 years) were studied before vascular surgery by dipyridamole stress echocardiography in 11 different centers. All patients underwent preoperative clinical risk assessment according to the American Heart Association guidelines. No majorcomplications occurred during dipyridamole stress echocardiography. Technically adequate images were obtained in all patients; however, in 4 patientsonly the low dipyridamole dose (0.56 mg/kg over 4 minutes) was given for limiting side effects. Eighty-eight (17.3%) had a positive test. Perioperative events occurred in 31 (6.1%) patients: 6 deaths, II myocardial infarctions, and 14 episodes of unstable angina. Sensitivity and specificity of dipyridamole stress echocardiography for predicting spontaneous cardiac events were 81% and 87%, respectively, with a positive predictive value of 28% andnegative predictive value of 99%. By multivariate analysis, the differencebetween wall motion score index at rest and peak stress (Delta wall motionscore index), test positivity, and ST-segment depression during dipyridamole infusion were independent predictors of any perioperative cardiac event. Conclusions-Dipyridamole stress echocardiography is safe and well tolerated in patients undergoing major vascular surgery and provides an effective preoperative screening test for the risk stratification of these patients, mainly because of the extremely high negative predictive value, which is a potent predictor of complication-free procedure.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 03/04/20 alle ore 14:05:07