非特異的なST-T異常を有する症状のある患者におけるトレッドミルの運動スコアの予後値,休息状態のECGでの予後値
J M Kwok1, T D Miller, T F Christian
1Department of Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minn 55905, USA.
JAMA
|September 24, 1999
まとめ
デューク・トレッドミルのスコアは,静止状態のECGでST-T異常を有する患者を効果的にリスク層に分けます. これらの異常を有する患者は,同様のリスクカテゴリー内であっても,正常なECGを有する患者と比較して,より悪い予後を呈する.
科学分野:
- 心臓病学 心臓病学
- 予防医学は,予防的な医療です.
- 診断用イメージング
背景:
- 冠動脈疾患に対する運動テストの特異性は,静止心電図に既にあるST-T異常によって低下する.
- ST-T異常を有する患者におけるデューク・トレッドミルのスコアの予後値は,以前に評価されていませんでした.
研究 の 目的:
- デューク・トレッドミルのスコアの予後精度を比較するために.
- 非特異的なST-T異常を持つ患者と,正常な休息状態のECGの患者における有効性を評価する.
主な方法:
- 7年間のフォローアップを伴う初期コホート研究設計.
- 運動タリウム検査を受けた症状のある患者も含まれていた.
- デューク・トレッドミルのスコアリスクグループによって階層化された全死亡率と心疾患による死亡率を分析した.
主要な成果:
- 心臓発作による死亡の7年生存率は97% (低リスク),92% (中間リスク),76% (高リスク) でした.
- ST-T異常を有する患者は,対照群と比較して7年生存率が低い (94%対98%),リスクの高い患者の割合が高い (5%対2%) であった.
- ST-T異常を有する高リスク患者の生存率が低下する傾向が観察されました.
結論:
- デューク・トレッドミルのスコアは,静止状態のECG ST-T異常を有する患者のリスク分層化に有効です.
- ST-T異常を有する患者は,分類されたリスクカテゴリー全体で正常な休息状態のECGを有する患者よりも悪い予後を示しています.
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