TY - JOUR
T1 - Prognosis of patients with good exercise capacity and mildly abnormal exercise echocardiography results
T2 - Identification of an at-risk subgroup
AU - McCully, Robert B.
AU - Ommen, Steve R.
AU - Klarich, Kyle W.
AU - Burger, Kelli N.
AU - Mahoney, Douglas W.
AU - Pellikka, Patricia A.
PY - 2005/6
Y1 - 2005/6
N2 - Background: Patients with good exercise capacity and mildly abnormal exercise echocardiography results have a favorable overall prognosis. Objective: We sought to define subgroups that might be at higher risk. Methods: We examined outcomes of 868 patients (women, < 5 metabolic equivalents; men, < 7 metabolic equivalents) with mild rest- or exercise-induced wall-motion abnormalities and evaluated potential predictors of time to cardiac death or nonfatal myocardial infarction (MI). Results: Mean age was 64 ± 10 years; 477 patients (55%) were men. Mean follow-up was 3.1 ± 1.5 years; cardiac event rate was 1.2% per person-year. A history of MI was the only significant predictor (risk ratio, 3.9; 95% confidence interval, 1.9-7.8; P =. 0001), with 1-, 3-, and 5-year event-free survival of 98.5% ± 1.1%, 92.6% ± 2.6%, and 83.3% ± 5.1%, respectively (event rate, 3.4%). Conclusions: Patients with a history of MI have a higher annual cardiac event rate and may benefit from reevaluation, whereas no history of MI connotes a favorable prognosis.
AB - Background: Patients with good exercise capacity and mildly abnormal exercise echocardiography results have a favorable overall prognosis. Objective: We sought to define subgroups that might be at higher risk. Methods: We examined outcomes of 868 patients (women, < 5 metabolic equivalents; men, < 7 metabolic equivalents) with mild rest- or exercise-induced wall-motion abnormalities and evaluated potential predictors of time to cardiac death or nonfatal myocardial infarction (MI). Results: Mean age was 64 ± 10 years; 477 patients (55%) were men. Mean follow-up was 3.1 ± 1.5 years; cardiac event rate was 1.2% per person-year. A history of MI was the only significant predictor (risk ratio, 3.9; 95% confidence interval, 1.9-7.8; P =. 0001), with 1-, 3-, and 5-year event-free survival of 98.5% ± 1.1%, 92.6% ± 2.6%, and 83.3% ± 5.1%, respectively (event rate, 3.4%). Conclusions: Patients with a history of MI have a higher annual cardiac event rate and may benefit from reevaluation, whereas no history of MI connotes a favorable prognosis.
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U2 - 10.1016/j.echo.2004.10.027
DO - 10.1016/j.echo.2004.10.027
M3 - Article
C2 - 15947766
AN - SCOPUS:20444425796
SN - 0894-7317
VL - 18
SP - 644
EP - 648
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 6
ER -