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systemic arteries in patients with myocardial infarction: a noninvasive method to predict severity of coronary atherosclerosis. Circulation 1989; 80: 78–86. [6] Madhavan S, Ooi WL, Cohen H, Alderman MH. Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction. Hypertension 1994; 23: 395–401. [7] Mitchell GF, Moye LA, Braunwald E et al. Sphygmomanometrically determined pulse pressure is a powerful independent predictor of recurrent events after myocardial infarction in patients with impaired left ventricular function. Circulation 1997; 96: 4254–60. [8] Tribouilloy C, Peltier M, Colas L, Rida Z, Rey JL, Lesbre JP. Multiplane transoesophageal echocardiographic absence of thoracic aortic plaque is a powerful predictor for absence of significant coronary artery disease in valvular patients, even in the elderly. A large prospective study. Eur Heart J 1997; 18: 1478–83. [9] Simons PCG, Algra A, Bots ML, Grobbee DE, van der Graaf Y. Common carotid intima-media thickness and arterial stiffness: Indicators of cardiovascular risk in high-risk patients. The SMART Study (Second Manifestation of ARTerial disease). Circulation 1999; 100: 951–7. [10] Bots ML, Hoes AW, Kousdstaai PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and risk of stroke and myocardial infarction. Circulation 1997; 96: 1432–7. [11] Grobbee DE, Bots ML. Carotid artery intima-media thickness as an indicator of generalized atherosclerosis. J Intern Med 1994; 13: 90–7. [12] Stefanadis C, Dernellis J, Tsiamis E et al. Aortic stiffness as a risk factor for recurrent acute coronary events in patients with ischemic heart disease. Eur Heart J 2000; 21: 390–6. [13] Domanski MJ, Mitchell GF, Norman JE, Exner DV, Pitt B, Pfeffer MA. Independent prognostic information provided by sphygmomanometrically determined pulse pressure and mean arterial pressure in patients with left ventricular dysfunction. J Am Coll Cardiol 1999; 33: 951–8. [14] Chae C, Pfeffer MA, Glynn RJ, Mitchell GF, Taylor JO, Hennekens CH. Increased pulse pressure and risk of heart failure in the elderly. JAMA 1999; 281: 634–43. [15] Mitchell GF, Pfeffer MA, Finn PV, Pfeffer JM. Myocarditis/ Hypertrophy/Congestive Heart Failure: Equipotent antihypertensive agents variously affect pulsatile hemodynamics and regression of cardiac hypertrophy in spontaneously hypertensive rats. Circulation 1996; 94: 2923–9.

Early risk-stratification in patients with angina but non-diagnostic ECG