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Incremental prognostic value of stress echocardiography with carotid ultrasound for suspected CAD
- Publication Year :
- 2016
- Publisher :
- Elsevier, 2016.
-
Abstract
- OBJECTIVES: This study hypothesized that ischemia and atherosclerosis assessment by ultrasound (US) may provide incremental prognostic information in patients with new-onset chest pain who do not have coronary artery disease (CAD). BACKGROUND: The clinical significance of atherosclerosis assessment by carotid US in patients undergoing stress echocardiography (SE) in such patients is unknown. METHODS: Consecutive patients with suspected angina but no history of CAD underwent simultaneous SE and US prospectively to assess myocardial ischemia and carotid plaque burden (CPB), respectively. Patients were followed up for major adverse events (MAEs)-all-cause mortality, nonfatal myocardial infarction, and unplanned coronary revascularization. RESULTS: Of 591 recruited patients, 580 (men, 46%; mean age 59 ± 11 years) patients were available for follow-up. SE demonstrated myocardial ischemia in 12%, but prevalence of carotid plaques was 59%. During a mean follow-up of 1,117 ± 361 days, 40 first MAEs occurred. In the multivariable regression model, pre-test probability (PTP) of CAD (p = 0.001), abnormal SE (p < 0.0001), and CPB (p < 0.0001) predicted MAEs. MAE rates per year increased from 0.9% versus 1.97% versus 4.3% versus 9.7% in patients with no carotid plaque and normal SE versus patients who had plaque and normal SE versus those with no plaque and abnormal SE versus patients with plaque and abnormal SE, respectively (p
- Subjects :
- Carotid Artery Diseases
Male
Time Factors
Cardiac & Cardiovascular Systems
carotid plaque
stress echocardiography
030204 cardiovascular system & hematology
Chest pain
Carotid Intima-Media Thickness
INTIMA-MEDIA THICKNESS
Coronary artery disease
Angina
0302 clinical medicine
Risk Factors
Prevalence
030212 general & internal medicine
Myocardial infarction
Prospective Studies
RISK
Radiology, Nuclear Medicine & Medical Imaging
ASSOCIATION
Middle Aged
PLAQUE
Plaque, Atherosclerotic
Progression-Free Survival
Cardiology
Disease Progression
CORONARY-ARTERY-DISEASE
Female
Radiology
medicine.symptom
Cardiology and Cardiovascular Medicine
Life Sciences & Biomedicine
coronary artery disease
Echocardiography, Stress
medicine.medical_specialty
Ischemia
Risk Assessment
1102 Cardiovascular Medicine And Haematology
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Stress Echocardiography
Humans
Radiology, Nuclear Medicine and imaging
Clinical significance
Angina, Stable
cardiovascular diseases
CARDIOVASCULAR EVENTS
METAANALYSIS
Aged
Science & Technology
business.industry
1103 Clinical Sciences
medicine.disease
Intima-media thickness
ATHEROSCLEROSIS
Cardiovascular System & Hematology
Cardiovascular System & Cardiology
business
PRIMARY PREVENTION
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....ed713fc57c4f1813a639489da632ed54