Prognostic impact of stress testing in coronary artery disease

Journal Article · Wed May 01 04:00:00 EDT 1991 · Circulation; (USA)

OSTI ID:5642747

Severi, S; Michelassi, C ^[1]

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1. CNR Clinical Physiology Institute, Pisa, (Italy)

Observational data prospectively collected permit the examination of a complex set of decisions, including the decision not to perform any stress testing. Patients with or without previous myocardial infarction admitted for coronary evaluation and not submitted to any stress testing because of clinical reasons are at a higher risk for subsequent death. For prognostication, no test has been better validated than exercise electrocardiography: it can identify patients at low and high risk for future cardiac events among those without symptoms, with typical chest pain, and with previous myocardial infarction. In patients with triple-vessel disease, the results of exercise also allow those at low and high risk to be recognized. Both exercise radionuclide angiography and {sup 201}Tl scintigraphy (the latter in larger patient populations) have also demonstrated significant prognostic value on patients with or without previous myocardial infarction. Neither one has shown superiority to the other in prognostication. So far, they have been considered the only viable alternatives to exercise electrocardiography stress testing for diagnosis and prognostication. However, their costs limit their extensive application. Preliminary data suggest that intravenous dipyridamole echocardiography can be used for both diagnosis and prognostication of coronary artery disease; moreover, the prognostic information derived from dipyridamole echocardiography testing seems independent of and additive to that provided by exercise electrocardiography. Further prospective studies on larger patient populations are needed to better define the prognostic value of dipyridamole echocardiography testing.47 references.

• OSTI ID: 5642747
• Journal Information: Circulation; (USA), Journal Name: Circulation; (USA) Vol. 83:5 Suppl; ISSN 0009-7322; ISSN CIRCA
• Country of Publication: United States
• Language: English

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550601* -- Medicine-- Unsealed Radionuclides in Diagnostics
62 RADIOLOGY AND NUCLEAR MEDICINE
BETA DECAY RADIOISOTOPES
BIOMEDICAL RADIOGRAPHY
BODY
CARDIOVASCULAR AGENTS
CARDIOVASCULAR DISEASES
CARDIOVASCULAR SYSTEM
COUNTING TECHNIQUES
DAYS LIVING RADIOISOTOPES
DECISION MAKING
DIAGNOSIS
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DIAGRAMS
DISEASES
DRUGS
ELECTROCARDIOGRAMS
ELECTRON CAPTURE RADIOISOTOPES
EXERCISE
HEART
HEAVY NUCLEI
IMAGE PROCESSING
ISOMERIC TRANSITION ISOTOPES
ISOTOPES
MEDICINE
MYOCARDIAL INFARCTION
NUCLEAR MEDICINE
NUCLEI
ODD-EVEN NUCLEI
ORGANS
PATIENTS
PROCESSING
RADIOISOTOPE SCANNING
RADIOISOTOPES
RADIOLOGY
RISK ASSESSMENT
SCINTISCANNING
SECONDS LIVING RADIOISOTOPES
THALLIUM 201
THALLIUM ISOTOPES
VASODILATORS