Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease: A coronary artery surgery study project

Magdi Sami, Bernard Chaitman, Lloyd Fisher, David Holmes, David Fray, Edwin Alderman

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

This retrospective study examines the prognostic significance of exercise-induced ventricular arrhythmia in patients with stable coronary artery disease (CAD) who were included in the multicenter patient registry of the Coronary Artery Surgery Study. The population is composed of 1,486 patients selected from 1975 to 1979 and followed an average of 4.3 years. All underwent a standard Bruce exercise test and had CAD by cardiac catheterization at entry. Patients were classified into group I or II depending on whether they had minimal or significant CAD. (Significant CAD was defined as 70% or greater diameter reduction in any major coronary artery or 50% or greater narrowing in the left main artery.) They were further subclassified into groups A or B depending on whether or not they had exercise-induced ventricular arrhythmia. Groups IA (16 patients) and IB (229 patients) had similar clinical and angiographic characteristics except for the average ejection fraction (EF), which was 50% for group IA and 64% for group IB (p <0.05). Group IIA (130 patients) had a higher prevalence of previous myocardial infarction, a lower mean EF and a higher proportion of patients with at least 2 coronary arteries significantly narrowed than group IIB (1,111 patients). The 5-year event-free survival was not influenced by the presence of exercise-induced ventricular arrhythmia; it was 76 and 88% in groups IA and IB, respectively (difference not significant), and 71 and 76% in groups IIA and IIB, respectively (difference not significant). Using a stepwise Cox regression analysis of selected clinical and angiographic risk factors, the only independent significant risk factors that were found for cardiac events in this patient population were the number of coronary arteries significantly narrowed and the left ventricular EF.

Original languageEnglish (US)
Pages (from-to)1182-1188
Number of pages7
JournalThe American journal of cardiology
Volume54
Issue number10
DOIs
StatePublished - Dec 1 1984
Externally publishedYes

Fingerprint

Cardiac Arrhythmias
Coronary Artery Disease
Coronary Vessels
Exercise
Cardiac Catheterization
Exercise Test
Stroke Volume
Population
Disease-Free Survival
Registries
Retrospective Studies
Arteries
Myocardial Infarction
Regression Analysis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease : A coronary artery surgery study project. / Sami, Magdi; Chaitman, Bernard; Fisher, Lloyd; Holmes, David; Fray, David; Alderman, Edwin.

In: The American journal of cardiology, Vol. 54, No. 10, 01.12.1984, p. 1182-1188.

Research output: Contribution to journalArticle

Sami, Magdi ; Chaitman, Bernard ; Fisher, Lloyd ; Holmes, David ; Fray, David ; Alderman, Edwin. / Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease : A coronary artery surgery study project. In: The American journal of cardiology. 1984 ; Vol. 54, No. 10. pp. 1182-1188.
@article{ea927073e2cf4c92a4ac8bb30e065766,
title = "Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease: A coronary artery surgery study project",
abstract = "This retrospective study examines the prognostic significance of exercise-induced ventricular arrhythmia in patients with stable coronary artery disease (CAD) who were included in the multicenter patient registry of the Coronary Artery Surgery Study. The population is composed of 1,486 patients selected from 1975 to 1979 and followed an average of 4.3 years. All underwent a standard Bruce exercise test and had CAD by cardiac catheterization at entry. Patients were classified into group I or II depending on whether they had minimal or significant CAD. (Significant CAD was defined as 70{\%} or greater diameter reduction in any major coronary artery or 50{\%} or greater narrowing in the left main artery.) They were further subclassified into groups A or B depending on whether or not they had exercise-induced ventricular arrhythmia. Groups IA (16 patients) and IB (229 patients) had similar clinical and angiographic characteristics except for the average ejection fraction (EF), which was 50{\%} for group IA and 64{\%} for group IB (p <0.05). Group IIA (130 patients) had a higher prevalence of previous myocardial infarction, a lower mean EF and a higher proportion of patients with at least 2 coronary arteries significantly narrowed than group IIB (1,111 patients). The 5-year event-free survival was not influenced by the presence of exercise-induced ventricular arrhythmia; it was 76 and 88{\%} in groups IA and IB, respectively (difference not significant), and 71 and 76{\%} in groups IIA and IIB, respectively (difference not significant). Using a stepwise Cox regression analysis of selected clinical and angiographic risk factors, the only independent significant risk factors that were found for cardiac events in this patient population were the number of coronary arteries significantly narrowed and the left ventricular EF.",
author = "Magdi Sami and Bernard Chaitman and Lloyd Fisher and David Holmes and David Fray and Edwin Alderman",
year = "1984",
month = "12",
day = "1",
doi = "10.1016/S0002-9149(84)80064-8",
language = "English (US)",
volume = "54",
pages = "1182--1188",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "10",

}

TY - JOUR

T1 - Significance of exercise-induced ventricular arrhythmia in stable coronary artery disease

T2 - A coronary artery surgery study project

AU - Sami, Magdi

AU - Chaitman, Bernard

AU - Fisher, Lloyd

AU - Holmes, David

AU - Fray, David

AU - Alderman, Edwin

PY - 1984/12/1

Y1 - 1984/12/1

N2 - This retrospective study examines the prognostic significance of exercise-induced ventricular arrhythmia in patients with stable coronary artery disease (CAD) who were included in the multicenter patient registry of the Coronary Artery Surgery Study. The population is composed of 1,486 patients selected from 1975 to 1979 and followed an average of 4.3 years. All underwent a standard Bruce exercise test and had CAD by cardiac catheterization at entry. Patients were classified into group I or II depending on whether they had minimal or significant CAD. (Significant CAD was defined as 70% or greater diameter reduction in any major coronary artery or 50% or greater narrowing in the left main artery.) They were further subclassified into groups A or B depending on whether or not they had exercise-induced ventricular arrhythmia. Groups IA (16 patients) and IB (229 patients) had similar clinical and angiographic characteristics except for the average ejection fraction (EF), which was 50% for group IA and 64% for group IB (p <0.05). Group IIA (130 patients) had a higher prevalence of previous myocardial infarction, a lower mean EF and a higher proportion of patients with at least 2 coronary arteries significantly narrowed than group IIB (1,111 patients). The 5-year event-free survival was not influenced by the presence of exercise-induced ventricular arrhythmia; it was 76 and 88% in groups IA and IB, respectively (difference not significant), and 71 and 76% in groups IIA and IIB, respectively (difference not significant). Using a stepwise Cox regression analysis of selected clinical and angiographic risk factors, the only independent significant risk factors that were found for cardiac events in this patient population were the number of coronary arteries significantly narrowed and the left ventricular EF.

AB - This retrospective study examines the prognostic significance of exercise-induced ventricular arrhythmia in patients with stable coronary artery disease (CAD) who were included in the multicenter patient registry of the Coronary Artery Surgery Study. The population is composed of 1,486 patients selected from 1975 to 1979 and followed an average of 4.3 years. All underwent a standard Bruce exercise test and had CAD by cardiac catheterization at entry. Patients were classified into group I or II depending on whether they had minimal or significant CAD. (Significant CAD was defined as 70% or greater diameter reduction in any major coronary artery or 50% or greater narrowing in the left main artery.) They were further subclassified into groups A or B depending on whether or not they had exercise-induced ventricular arrhythmia. Groups IA (16 patients) and IB (229 patients) had similar clinical and angiographic characteristics except for the average ejection fraction (EF), which was 50% for group IA and 64% for group IB (p <0.05). Group IIA (130 patients) had a higher prevalence of previous myocardial infarction, a lower mean EF and a higher proportion of patients with at least 2 coronary arteries significantly narrowed than group IIB (1,111 patients). The 5-year event-free survival was not influenced by the presence of exercise-induced ventricular arrhythmia; it was 76 and 88% in groups IA and IB, respectively (difference not significant), and 71 and 76% in groups IIA and IIB, respectively (difference not significant). Using a stepwise Cox regression analysis of selected clinical and angiographic risk factors, the only independent significant risk factors that were found for cardiac events in this patient population were the number of coronary arteries significantly narrowed and the left ventricular EF.

UR - http://www.scopus.com/inward/record.url?scp=0021682667&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0021682667&partnerID=8YFLogxK

U2 - 10.1016/S0002-9149(84)80064-8

DO - 10.1016/S0002-9149(84)80064-8

M3 - Article

C2 - 6507288

AN - SCOPUS:0021682667

VL - 54

SP - 1182

EP - 1188

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 10

ER -