False-positive stress echocardiograms: Predictors and prognostic relevance

Area of Science:

• Cardiology
• Diagnostic Imaging

Background:

• Increasing evidence suggests overestimation of coronary artery disease (CAD) likelihood and decreasing positive stress test results.
• This trend indicates a higher prevalence of false-positive (FP) stress tests, necessitating further investigation.

Purpose of the Study:

• To identify predictors of false-positive stress echocardiography (SE) results.
• To compare patient outcomes between false-positive (FP) and true-positive (TP) SE findings.

Main Methods:

• Retrospective review of 1069 patients (aged ≥40) who underwent SE and cardiac catheterization (CC) between 2013-2017.
• FP SE defined as new/worsening wall motion abnormality without significant CAD (≥50% stenosis).

Main Results:

• 53% of positive SE results (162/305) were false-positive.
• Independent predictors of FP SE included female gender, absence of diabetes, no prior CAD history, and lower stress WMSI.
• Patients with FP SE showed similar all-cause mortality compared to TP SE patients.

Conclusions:

• Identifying FP SE predictors can refine test interpretation and reduce unnecessary cardiac catheterizations.
• Patients with FP SE may benefit from intensified risk factor management and close clinical monitoring.