Key result
Normal exercise MPI and echo show ~99% negative predictive value for MI and cardiac death.
Why the study?
The study was conducted to determine the prognostic value of normal exercise MPI and exercise echocardiography tests, including their prognostic value specifically in women and men.
What is the prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography for predicting MI and cardiac death in patients with suspected CAD?
Population
Subjects undergoing exercise MPI or exercise echocardiography for known or suspected CAD
Comparison
Normal exercise MPI vs normal exercise echocardiography
Design
Systematic review and meta-analysis of prospective cohort studies
Follow-up
At least 3 months (36 months for MPI, 33 months for echocardiography)
Authors
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Normal exercise MPI and exercise echocardiography both have high negative predictive values for primary cardiac events, with annualized event rates around 0.5%, similarly in men and women.
Meta-Analysis
What is the prognostic value of normal exercise myocardial perfusion imaging and exercise echocardiography for predicting MI and cardiac death in patients with suspected CAD?
Absolute Event Rate: 0.45% vs 0.54%
Normal exercise MPI and exercise echocardiography both have high negative predictive values for primary cardiac events, with annualized event rates around 0.5%, similarly in men and women.
Metz et al. (2006) conducted a meta-analysis in suspected coronary artery disease (CAD). Normal exercise myocardial perfusion imaging (MPI) vs. Normal exercise echocardiography was evaluated on Myocardial infarction (MI) and cardiac death. Normal exercise myocardial perfusion imaging and exercise echocardiography demonstrated high negative predictive values for MI and cardiac death (98.8% and 98.4%, respectively).
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