A positive dipyridamole echocardiography test was associated with significantly lower long-term survival compared to a negative test (75.7% vs. 90.0% at 140 months; P=0.0018).
Cohort (n=457)
Does a positive dipyridamole echocardiography test predict worse survival in patients with chest pain and angiographically normal or near-normal coronary arteries?
Dipyridamole stress echocardiography provides incremental prognostic value for long-term survival in patients with chest pain and non-obstructive coronary artery disease.
Hazard Ratio: 6.7 (95% CI 2.5–17.8)
Absolute Event Rate: 75.7% vs 90%
p-value: p=0.0018
AIMS: Patients with normal coronary arteries have a heterogeneous prognosis. Aim of this study was to assess whether dipyridamole stress echocardiography positivity identifies a prognostically less benign subset. METHODS AND RESULTS: We selected 457 patients (245 males; 56+/-10 years) who underwent stress high-dose dipyridamole echocardiography and had angiographically non-significant (<50% visually assessed) stenosis in any major vessel and preserved left ventricular function. All patients were followed up for a median of 7.1 years (first quartile 5 and third quartile 10.5). Dipyridamole echocardiography test (DET) positivity for regional dysfunction occurred in 43(9%) patients. Kaplan-Meier survival estimates showed a significant better outcome for those patients with negative dipyridamole echocardiography test compared with those with a positive test (90 vs. 75.7%, at 140 months of follow-up, P=0.0018). At multivariable analysis, mild or moderate irregularity on coronary arteriogram (HR=3.3, CI 95%=1.7-6.2), diabetes (HR=3.5, CI 95%=1.4-9.2), and wall motion score index at peak stress (HR=6.7, CI 95%=2.5-17.8) were independent predictors of all-cause death. CONCLUSION: DET adds incremental value to the prognostic stratification achieved with clinical and angiographic data in the subset of patients with normal or near-normal coronary arteries.
Sicari et al. (Wed,) conducted a cohort in Chest pain syndrome with angiographically normal or near-normal coronary arteries (n=457). Dipyridamole echocardiography test (DET) positivity vs. Negative dipyridamole echocardiography test was evaluated on Survival at 140 months (HR 6.7, 95% CI 2.5-17.8, p=0.0018). A positive dipyridamole echocardiography test was associated with significantly lower long-term survival compared to a negative test (75.7% vs. 90.0% at 140 months; P=0.0018).