The exercise test that indicates a low risk of events: Differences in prognostic significance between patients with chronic stable angina and patients with unstable angina

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• 作者：Rafael Florenciano-Sá ; nchez ; Juan A. Castillo-Moreno ; Eduardo Molina-Laborda ; Manuel Jimé ; nez-Pascual ; Pedro Garcí ; a-Urruticoechea ; Santiago Egea-Beneyto ; José ; G. Sá ; nchez-Villanu
• 关键词：ACC/AHA Scientific Statements ; coronary disease ; electrocardiography ; exercise ; tests
• 刊名：Journal of the American College of Cardiology
• 出版年：2001
• 出版时间：December 2001
• 年：2001
• 卷：38
• 期：7
• 页码：1974-1979
• 全文大小：89 K

文摘

The objective of this prospective study was to determine the differences in the prognostic significance of an exercise test (ET) that indicates a low risk of events (low-risk exercise test [LRET]) between patients with unstable angina (UA) and those with chronic stable angina (CSA).

Background

It is not known whether the prognostic significance of an LRET is influenced by the disease; that is the reason for performing exercise testing.

Methods

All patients not presenting with high-risk criteria were submitted to a prognostic ET. The ET was performed by patients with CSA and patients with primary UA stabilized with medical therapy. Medical therapy was planned for all patients. A combined end point was defined as cardiac death, nonfatal acute myocardial infarction or hospital admission for UA. Multivariate analysis was performed to determine the independent predictors of events.

Results

Low-risk criteria were fulfilled by 105 patients with UA and 86 patients with CSA. The mean follow-up time was 347 ± 229 days. The event rate was higher in the UA group than in the CSA group (28 % vs. 9 % , P = 0.001). The CSA group showed worse ET results. Performance of ET by patients with UA was the principal predictor of events (odds ratio 4.2, P = 0.0005).

Conclusions

Among patients who underwent an LRET, those with UA had a rate of events significantly higher than that of patients with CSA, despite the worse results of ET in patients with CSA.