Prognostic Significance of Myocardial Ischemia by Dobutamine Stress Echocardiography in Patients Without Angina Pectoris After Coronary Revascularization

Pedone, Chiara; Elhendy, Abdou; Biagini, Elena; van Domburg, Ron T.; Schinkel, Arend F.; Di Pasquale, Giuseppe; Bax, Jeroen J.; Poldermans, Don

doi:10.1016/j.amjcard.2008.06.040

« Previous Next »American Journal of Cardiology
Volume 102, Issue 9 , Pages 1156-1158, 1 November 2008

Prognostic Significance of Myocardial Ischemia by Dobutamine Stress Echocardiography in Patients Without Angina Pectoris After Coronary Revascularization

Chiara Pedone, MD
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Department of Cardiology, Maggiore Hospital, Bologna, Italy
Abdou Elhendy, MD, PhD
- Department of Cardiology, Marshfield Clinic, Marshfield, Wisconsin
Elena Biagini, MD, PhD
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Ron T. van Domburg, PhD
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Arend F. Schinkel, MD, PhD
- Department of Cardiology, Erasmus University Medical Centre, Rotterdam, the Netherlands
Giuseppe Di Pasquale, MD
- Department of Cardiology, Maggiore Hospital, Bologna, Italy
Jeroen J. Bax, MD, PhD
- Department of Cardiology, Leiden Medical Centre, Leiden, the Netherlands
Don Poldermans, MD, PhD
- Department of Vascular Surgery, Erasmus University Medical Centre, Rotterdam, the Netherlands
- Corresponding author: Tel: +31104634613; fax: +31104362995

Received 26 March 2008; received in revised form 17 June 2008; accepted 17 June 2008. published online 29 August 2008.

The clinical utility of stress testing in patients without angina pectoris after revascularization has been questioned. Dobutamine stress echocardiography (DSE) is an established technique for detection of myocardial ischemia and cardiac risk stratification. We studied the prognostic value of DSE in 393 patients without typical angina pectoris after coronary revascularization. Ischemia was incremental to clinical data in predicting all-cause death (hazard ratio 3.5, 95% confidence interval 1.8 to 6.7) and cardiac death (hazard ratio 4.2, 95% confidence interval 1.8 to 9.8). In conclusion, myocardial ischemia during DSE is independently associated with an increased risk of all-cause mortality and cardiac death in these patients after adjustment for clinical data.