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Title: Prognostic impact of stress testing in coronary artery disease

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 echocardiographymore » 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.« less
Authors:
;  [1]
  1. (CNR Clinical Physiology Institute, Pisa, (Italy))
Publication Date:
OSTI Identifier:
5642747
Resource Type:
Journal Article
Resource Relation:
Journal Name: Circulation; (USA); Journal Volume: 83:5 Suppl
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; HEART; IMAGE PROCESSING; BIOMEDICAL RADIOGRAPHY; DECISION MAKING; ELECTROCARDIOGRAMS; EXERCISE; MYOCARDIAL INFARCTION; PATIENTS; RISK ASSESSMENT; SCINTISCANNING; THALLIUM 201; VASODILATORS; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR AGENTS; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DIAGRAMS; DISEASES; DRUGS; ELECTRON CAPTURE RADIOISOTOPES; HEAVY NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANS; PROCESSING; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; SECONDS LIVING RADIOISOTOPES; THALLIUM ISOTOPES 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics