Key result
Mental stress-induced ischemia is associated with a ~21% absolute increase in subsequent cardiac events.
Why the study?
The prognostic value of mental stress-induced ischemic left ventricular wall motion abnormalities and hemodynamic responses in stable CAD patients with prior positive exercise tests was unclear.
Does mental stress-induced ischemia and hemodynamic response predict subsequent cardiac events in patients with stable CAD?
Cohort (n=79)
Does mental stress-induced ischemia and hemodynamic response predict subsequent cardiac events in patients with stable CAD?
Absolute Event Rate: 44% vs 23%
p-value: p=0.048
Mental stress testing can identify stable CAD patients at higher risk for subsequent cardiac events based on ischemic wall motion abnormalities and diastolic blood pressure responses.
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May refine risk stratification in stable CAD; hypothesis-generating and should not yet change practice.
Krantz et al. (1999) conducted a cohort in Stable coronary artery disease (CAD) (n=79). Mental stress ischemia vs. No mental stress ischemia was evaluated on Subsequent cardiac events (including cardiac death, nonfatal myocardial infarction, or revascularization procedures) (p=0.048). Mental stress-induced ischemia (44% vs 23%; p=0.048) and high diastolic blood pressure responses (RR 2.4; 95% CI 1.1-5.2) were associated with increased risk of subsequent cardiac events.
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