Prognostic Value of Stress Echocardiography in Patients With Low-Intermediate or High Short-Term (10 Years) Versus Low (<39%) or High (>/=39%) Lifetime Predicted Risk of Cardiovascular Disease According to the American College of Cardiology/American Heart Association 2013 Cardiovascular Risk Calculator
Publication Date
2015
Journal Title
Am J Cardiol
Abstract
This study evaluates the prognostic value of stress echocardiography (Secho) in short-term (10 years) and lifetime atherosclerotic cardiovascular disease risk-defined groups according to the American College of Cardiology/American Heart Association 2013 cardiovascular risk calculator. The ideal risk assessment and management of patients with low-to-intermediate or high short-term versus low (/=39%) lifetime CV risk is unclear. The purpose of this study was to evaluate the prognostic value of Secho in short-term and lifetime CV risk-defined groups. We evaluated 4,566 patients (60 +/- 13 years; 46% men) who underwent Secho (41% treadmill and 59% dobutamine) with low-intermediate short-term (/=39%, n = 661) lifetime CV risk and third group with high short-term risk (>/=20%, n = 3,537). Follow-up (3.2 +/- 1.5 years) for nonfatal myocardial infarction (n = 102) and cardiac death (n = 140) were obtained. By univariate analysis, age (p/=3 new ischemic wall motion abnormalities (WMAs, p/=3 WMA versus(3.3% vs 0.3% per year, p/=3 new ischemic WMAs as the strongest predictor of cardiac events (hazard ratio 3.0, 95% confidence interval 2.3 to 3.9, p/=3 new ischemic segments) can further refine risk assessment in patients with low-intermediate or high short-term versus low or high lifetime cardiovascular risk. Event rate with normal Secho is low (
Volume Number
116
Issue Number
5
Pages
725-9
Document Type
Article
EPub Date
2015/07/04
Status
Faculty, Northwell Researcher
Facility
School of Medicine; Northwell Health
Primary Department
Cardiology
PMID
DOI
10.1016/j.amjcard.2015.05.040