Characteristics and Outcomes of Patients With Abnormal Stress Echocardiograms and Angiographically Mild Coronary Artery Disease (<50% Stenoses) or Normal Coronary Arteries

Aaron M. From, Garvan M Kane, Charles J Bruce, Patricia Pellikka, Christopher Scott, Robert B. McCully

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29 Citations (Scopus)

Abstract

Background: Abnormal cardiac stress imaging findings are not always associated with angiographically significant coronary artery disease. The outcomes of patients with such false-positive findings have not been extensively examined. The aim of this retrospective study was to describe the characteristics and outcomes of patients with abnormal stress echocardiographic findings who had false-positive results compared with those who had true-positive results. Methods: Of 1,477 consecutive patients (mean age, 66 ± 12 years; 61% men) with abnormal stress echocardiographic findings who underwent coronary arteriography within 30 days, death from any cause was ascertained. Results: At coronary arteriography, 997 patients (67.5%) had true-positive results, defined by the presence of angiographically significant coronary artery disease (≥50% stenoses), and 480 (32.5%) had false-positive results, defined by <50% stenoses or normal coronary arteries. Of the subgroup of patients with markedly abnormal stress echocardiographic findings (n = 605), 28% had <50% stenoses or normal coronary arteries. During an average follow-up period of 2.4 ± 1.0 years, there were 140 deaths. The adjusted likelihood of subsequent death for patients with <50% stenoses compared to patients with ≥50% stenoses after abnormal stress echocardiography was 1.05 (95% confidence interval, 0.86-1.31; P = .62). Conclusions: A sizable proportion of patients with abnormal stress echocardiographic results who are referred for coronary angiography have false-positive findings. The outcomes of patients with false-positive results were similar to those of patients with true-positive results. This finding suggests that patients with false-positive results on stress echocardiography should still receive intensive risk factor management and careful clinical follow-up.

Original languageEnglish (US)
Pages (from-to)207-214
Number of pages8
JournalJournal of the American Society of Echocardiography
Volume23
Issue number2
DOIs
StatePublished - Feb 2010

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Coronary Artery Disease
Coronary Vessels
Pathologic Constriction
Stress Echocardiography
Angiography
Risk Management
Coronary Angiography
Cause of Death
Retrospective Studies
Confidence Intervals

Keywords

  • Coronary angiography
  • Dobutamine stress echocardiography
  • Exercise echocardiography
  • Stress echocardiography

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

@article{7287125ae7ff480aae75ec2f4823101e,
title = "Characteristics and Outcomes of Patients With Abnormal Stress Echocardiograms and Angiographically Mild Coronary Artery Disease (<50{\%} Stenoses) or Normal Coronary Arteries",
abstract = "Background: Abnormal cardiac stress imaging findings are not always associated with angiographically significant coronary artery disease. The outcomes of patients with such false-positive findings have not been extensively examined. The aim of this retrospective study was to describe the characteristics and outcomes of patients with abnormal stress echocardiographic findings who had false-positive results compared with those who had true-positive results. Methods: Of 1,477 consecutive patients (mean age, 66 ± 12 years; 61{\%} men) with abnormal stress echocardiographic findings who underwent coronary arteriography within 30 days, death from any cause was ascertained. Results: At coronary arteriography, 997 patients (67.5{\%}) had true-positive results, defined by the presence of angiographically significant coronary artery disease (≥50{\%} stenoses), and 480 (32.5{\%}) had false-positive results, defined by <50{\%} stenoses or normal coronary arteries. Of the subgroup of patients with markedly abnormal stress echocardiographic findings (n = 605), 28{\%} had <50{\%} stenoses or normal coronary arteries. During an average follow-up period of 2.4 ± 1.0 years, there were 140 deaths. The adjusted likelihood of subsequent death for patients with <50{\%} stenoses compared to patients with ≥50{\%} stenoses after abnormal stress echocardiography was 1.05 (95{\%} confidence interval, 0.86-1.31; P = .62). Conclusions: A sizable proportion of patients with abnormal stress echocardiographic results who are referred for coronary angiography have false-positive findings. The outcomes of patients with false-positive results were similar to those of patients with true-positive results. This finding suggests that patients with false-positive results on stress echocardiography should still receive intensive risk factor management and careful clinical follow-up.",
keywords = "Coronary angiography, Dobutamine stress echocardiography, Exercise echocardiography, Stress echocardiography",
author = "From, {Aaron M.} and Kane, {Garvan M} and Bruce, {Charles J} and Patricia Pellikka and Christopher Scott and McCully, {Robert B.}",
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T1 - Characteristics and Outcomes of Patients With Abnormal Stress Echocardiograms and Angiographically Mild Coronary Artery Disease (<50% Stenoses) or Normal Coronary Arteries

AU - From, Aaron M.

AU - Kane, Garvan M

AU - Bruce, Charles J

AU - Pellikka, Patricia

AU - Scott, Christopher

AU - McCully, Robert B.

PY - 2010/2

Y1 - 2010/2

N2 - Background: Abnormal cardiac stress imaging findings are not always associated with angiographically significant coronary artery disease. The outcomes of patients with such false-positive findings have not been extensively examined. The aim of this retrospective study was to describe the characteristics and outcomes of patients with abnormal stress echocardiographic findings who had false-positive results compared with those who had true-positive results. Methods: Of 1,477 consecutive patients (mean age, 66 ± 12 years; 61% men) with abnormal stress echocardiographic findings who underwent coronary arteriography within 30 days, death from any cause was ascertained. Results: At coronary arteriography, 997 patients (67.5%) had true-positive results, defined by the presence of angiographically significant coronary artery disease (≥50% stenoses), and 480 (32.5%) had false-positive results, defined by <50% stenoses or normal coronary arteries. Of the subgroup of patients with markedly abnormal stress echocardiographic findings (n = 605), 28% had <50% stenoses or normal coronary arteries. During an average follow-up period of 2.4 ± 1.0 years, there were 140 deaths. The adjusted likelihood of subsequent death for patients with <50% stenoses compared to patients with ≥50% stenoses after abnormal stress echocardiography was 1.05 (95% confidence interval, 0.86-1.31; P = .62). Conclusions: A sizable proportion of patients with abnormal stress echocardiographic results who are referred for coronary angiography have false-positive findings. The outcomes of patients with false-positive results were similar to those of patients with true-positive results. This finding suggests that patients with false-positive results on stress echocardiography should still receive intensive risk factor management and careful clinical follow-up.

AB - Background: Abnormal cardiac stress imaging findings are not always associated with angiographically significant coronary artery disease. The outcomes of patients with such false-positive findings have not been extensively examined. The aim of this retrospective study was to describe the characteristics and outcomes of patients with abnormal stress echocardiographic findings who had false-positive results compared with those who had true-positive results. Methods: Of 1,477 consecutive patients (mean age, 66 ± 12 years; 61% men) with abnormal stress echocardiographic findings who underwent coronary arteriography within 30 days, death from any cause was ascertained. Results: At coronary arteriography, 997 patients (67.5%) had true-positive results, defined by the presence of angiographically significant coronary artery disease (≥50% stenoses), and 480 (32.5%) had false-positive results, defined by <50% stenoses or normal coronary arteries. Of the subgroup of patients with markedly abnormal stress echocardiographic findings (n = 605), 28% had <50% stenoses or normal coronary arteries. During an average follow-up period of 2.4 ± 1.0 years, there were 140 deaths. The adjusted likelihood of subsequent death for patients with <50% stenoses compared to patients with ≥50% stenoses after abnormal stress echocardiography was 1.05 (95% confidence interval, 0.86-1.31; P = .62). Conclusions: A sizable proportion of patients with abnormal stress echocardiographic results who are referred for coronary angiography have false-positive findings. The outcomes of patients with false-positive results were similar to those of patients with true-positive results. This finding suggests that patients with false-positive results on stress echocardiography should still receive intensive risk factor management and careful clinical follow-up.

KW - Coronary angiography

KW - Dobutamine stress echocardiography

KW - Exercise echocardiography

KW - Stress echocardiography

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