Prognostic significance of silent myocardial ischemia on a thallium stress test
| Autor: | Mary E. Tresgallo, David W. Seldin, Louis I. Heller, David K. Blood, Lynne L. Johnson, Robert R. Sciacca |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Time Factors medicine.medical_treatment Ischemia Infarction Coronary Disease Scintigraphy Revascularization Asymptomatic Angina Pectoris Angina Electrocardiography Internal medicine medicine Humans Clinical significance cardiovascular diseases Myocardial infarction Radionuclide Imaging medicine.diagnostic_test business.industry Heart Middle Aged Prognosis medicine.disease Thallium Radioisotopes Exercise Test Cardiology Female medicine.symptom Cardiology and Cardiovascular Medicine business Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 65:718-721 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/0002-9149(90)91377-i |
| Popis: | The clinical significance of silent ischemia is not fully known. The purpose of this study was to determine whether the presence or absence of angina during a thallium stress test positive for ischemia was independently predictive of an adverse outcome. Two hundred thirty-four consecutive patients with ischemia on a thallium stress test were identified. Ischemia was defined as the presence of defect(s) on the immediate postexercise scans not in the distribution of prior infarctions that redistributed on 4-hour scans. During the test 129 patients had angina, defined as characteristic neck, jaw, arm, back or chest discomfort, while the remaining 105 patients had no angina. Follow-up ranged from 2 to 8.2 years (mean 5.2 +/- 2.1) and was successfully obtained in 156 patients. Eighty-two of the 156 patients had angina (group A) and 74 had silent ischemia (group S). Group A patients were significantly older (62 +/- 8 vs 59 +/- 8 years, p less than 0.05). There was no significant difference between the 2 groups in terms of sex, history of prior infarction or presence of left main/3-vessel disease. A larger percentage of patients in group A were receiving beta blockers (60 vs 41%, p less than 0.05) and nitrates (52 vs 36%, 0.05 less than p less than 0.10). There was a large number of cardiac events (myocardial infarction, revascularization and death) in both groups (37 of 82 [45%] in group A; 28 of 72 [38%] in group S) but no statistically significant difference between the groups. Similarly, life-table analysis revealed no difference in mortality between the 2 groups.(ABSTRACT TRUNCATED AT 250 WORDS) |
| Databáze: | OpenAIRE |
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