Related Experiment Videos
Influence of Cardiovascular Risk in the Prediction and Timing of Cardiac Events After Exercise Echocardiogram Testing
Sonia Velasco Del Castillo1, Ane Antón Ladislao2, Verónica Gómez Sánchez2
1Servicio de Cardiología, Hospital de Galdakao, Galdakao, Vizcaya, Spain.
Insights
Cardiovascular risk factors significantly predict cardiac events in patients undergoing exercise echocardiography (EE) without ischemia. High cardiovascular risk, indicated by SCORE ≥ 10 or diabetes, impacts long-term event-free survival.
Area of Science:
- Cardiology
- Preventive Cardiology
- Diagnostic Imaging
Background:
- Exercise echocardiography (EE) is used to assess cardiac function.
- The predictive value of cardiovascular risk in patients with EE showing no ischemia is not well-established.
- Understanding risk factors is crucial for patient management.
Purpose of the Study:
- To analyze cardiovascular risk as a predictor of cardiac events in patients with normal EE.
- To identify key predictors of cardiac events in this specific patient cohort.
Main Methods:
- 1640 patients with EE without ischemia were analyzed.
- Patients were stratified by known coronary artery disease (CAD) and European SCORE risk assessment.
- Cardiac event-free survival (EFS) was the primary endpoint.
Main Results:
- Patients with SCORE ≥ 10 or diabetes had similar cardiac EFS to those with prior CAD.
- Annualized event rates were significantly higher in high-risk groups (SCORE ≥ 10/diabetes) compared to lower-risk groups.
- Predictors included prior CAD, high SCORE, diabetes, creatinine clearance, ejection fraction, and chest pain during EE.
Conclusions:
- Patients undergoing EE without ischemia have a generally favorable initial outcome.
- Long-term cardiac event risk is significantly influenced by established cardiovascular risk factors.
- Risk stratification using tools like SCORE is essential for managing patients post-EE.
Introduction And Objectives:
There have been no analyses of the influence of cardiovascular risk as a predictor of events in patients with exercise echocardiography (EE) without ischemia. Our objective was to determine the predictors of cardiac events, paying special attention to cardiovascular risk.
Methods:
This study included 1640 patients with EE without ischemia. Of these, there were 1206 with no previously known coronary artery disease (CAD), whose risk of a fatal cardiovascular disease event was estimated according to the European SCORE (Systematic COronary Risk Evaluation) risk assessment system, and 434 with known CAD. The primary endpoint was cardiac event-free survival (EFS) (cardiac death, nonfatal acute coronary syndrome, and coronary revascularization).
Results:
After a median follow-up of 35 [23-54] months, no differences were found in cardiac EFS between patients with a SCORE ≥ 10 or diabetes and patients with previous CAD (89.8% vs 87.1%). In the first year, cardiac EFS was high in all groups (99.4% if SCORE < 5; 100% if 5-9; 98% if ≥ 10 or diabetes and 97% in patients with CAD). In the third year, cardiac EFS was similar in the group with SCORE ≥ 10 or diabetes (94.5%) and patients with CAD (91.1%, P = NS). In these patients, the annualized event rate was 2.8% and 2.55%, respectively, and was significantly higher than in groups with SCORE < 5 (0.6%) and SCORE 5-9 (0.12%). The most frequent events were non-ST-segment elevation acute coronary syndrome and late revascularization. Predictors of cardiac events were previous CAD, SCORE ≥ 10 or diabetes mellitus, creatinine clearance, left ventricular ejection fraction, and chest pain during EE.
Conclusions:
Initial outcome after an EE without ischemia is favorable but is subsequently modulated by cardiovascular risk.