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Independent and incremental prognostic value of exercise stress echocardiography in low cardiovascular risk female patients with chest pain
Author(s) -
Park SungJi,
Chung Seungmin,
Chang SungA,
Choi JinOh,
Choi JinHo,
Lee SangChol,
Park Seung Woo
Publication year - 2017
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.13388
Subject(s) - mace , medicine , chest pain , coronary artery disease , cardiology , hazard ratio , stress echocardiography , multivariate analysis , physical therapy , myocardial infarction , confidence interval , conventional pci
Background Exercise stress echocardiography ( ESE cho) is sufficiently sensitive and has high enough specificity for the clinical detection of coronary artery disease ( CAD ) in women. However, there was little data about the ability of ESE cho to detect CAD and predict clinical outcomes in female patients with chest pain and low global cardiovascular ( CV ) risks. The purposes of this study were (1) to determine the diagnostic accuracy of ESE cho, (2) to evaluate the clinical outcomes of major cardiovascular outcome ( MACE ), and (3) to assess the incremental prognostic value of ESE cho for the prediction of MACE in Korean female patients with low CV risks. Methods Over a period of 15 years, 3396 patients (57±10 years) female patients with chest pain but no previous history of CAD undergoing ESE cho and exercise stress electrocardiography ( ESECG ) were assessed. Results During a median follow‐up period of 4.8 years (2.8‐6.2 years), there were 19 (0.61%) MACE . Positive results for ESE cho were seen in 134 patients (3.9%). The sensitivity and specificity of ESE cho were 66.7% and 84.8%, respectively. Positive ESE cho was an independent predictor of MACE (multivariate hazard ratio: 0.019, 95% CI : 0.004‐0.081). ESE cho was incremental to clinical and ESECG parameters to predict the MACE in low CV risk women. Conclusions ESE cho is effective for the diagnosis of CAD in Korean female patients with chest pain, a population characterized by low cardiovascular risk profiles. Positive ESE cho was an independent predictor of MACE , and negative results were associated with favorable clinical outcomes. ESE cho was incremental to clinical and ESECG parameters to predict the MACE in low CV risk women.