Value of the coronary artery disease consortium rule in patients with acute chest pain and negative troponins referred for exercise stress testing.

Objective: To assess the value of the pretest probability (PTP) of coronary artery disease (CAD) for predicting stress testing results and coronary events in patients with acute chest pain and negative troponins.

Patients And Methods: A total of 3527 patients without a history of CAD referred to our chest pain unit with suspected acute coronary syndromes, nondiagnostic ECGs, and negative troponin levels underwent exercise stress testing. PTP was estimated with the CAD consortium prediction rule, and was categorized as low (<15%), low-intermediate (15-65%), intermediate-high (66-85%), and high (>85%).

[Diagnostic and prognostic efficiency of 24-hour Holter monitoring in patients with syncope].

Background And Objective: Syncope is a common condition and complex to diagnose. The yield of the 24h-Holter ECG in this context has not been clearly defined. The aim of this study was to evaluate its diagnostic and prognostic capacity in these patients.

A clinical score to obviate the need for cardiac stress testing in patients with acute chest pain and negative troponins.

Introduction: Although cardiac stress testing may help establish the safety of early discharge in patients with suspected acute coronary syndromes and negative troponins, more cost-effective strategies are necessary. We aimed to develop a clinical prediction rule to safely obviate the need for cardiac stress testing in this setting.

Methods: A decision rule was derived in a prospective cohort of 3001 patients with acute chest pain and negative troponins, and validated in a set of 1473 subjects.

Troponin levels within the normal range and probability of inducible myocardial ischemia and coronary events in patients with acute chest pain.

Background/objectives: Patients with suspected acute coronary syndromes and negative cardiac troponin (cTn) levels are deemed at low risk. Our aim was to assess the effect of cTn levels on the frequency of inducible myocardial ischemia and subsequent coronary events in patients with acute chest pain and cTn levels within the normal range.

Methods: We evaluated 4474 patients with suspected acute coronary syndromes, nondiagnostic electrocardiograms and serial cTnI levels below the diagnostic threshold for myocardial necrosis using a conventional or a sensitive cTnI assay.

Trends in referral patterns, invasive management, and mortality in elderly patients referred for exercise stress testing.

Introduction: Scarce data are available on the temporal patterns in clinical characteristics and outcomes of elderly patients referred for exercise stress testing. We aimed to assess the trends in baseline characteristics, tests results, referrals for invasive management, and mortality in these patients.

Methods: We evaluated 11,192 patients aged ≥65years who were referred for exercise stress testing between January 1998 and December 2013.

Incremental value of exercise echocardiography over exercise electrocardiography in a chest pain unit.

Background: Limited data are available on the added value of exercise echocardiography (ExEcho) over exercise electrocardiography (ExECG) in patients with suspected acute coronary syndromes (ACS) referred to a chest pain unit. We aimed to assess the incremental value of ExEcho over ExECG in this setting.

Methods: ExECG and ExEcho were performed in parallel in 1052 patients with suspected ACS, nondiagnostic but interpretable electrocardiograms, and negative serial troponin results.

Temporal changes in the use and results of exercise echocardiography.

Aims: Limited data are available regarding changes over time in referral patterns and outcomes of non-invasive cardiac stress testing. Our aim was to evaluate the temporal changes in the use and results of exercise echocardiography in our area of reference.

Methods And Results: A total of 12 339 patients referred to our unit for exercise echocardiography between 1997 and 2012 were included.

Exaggerated exercise blood pressure response and risk of stroke in patients referred for stress testing.

Background/objectives: There is some evidence to suggest that exercise systolic blood pressure (SBP) may be associated with future risk of stroke in subjects without a history of coronary artery disease (CAD). However, the value of an exaggerated exercise SBP response (EESBPR) for predicting stroke in patients referred for stress testing for clinical reasons has not been investigated.

Methods: We evaluated a community-based sample of 10,047 patients with known or suspected CAD who underwent treadmill exercise echocardiography.

Association of left ventricular mass with all-cause mortality, myocardial infarction and stroke.

Background: Our aim was to assess the association of left ventricular mass with mortality and nonfatal cardiovascular events.

Methodology/principal Findings: Left ventricular mass was measured by echocardiography in 40138 adult patients (mean age 61.1 ± 16.

Impact of electrocardiographic interpretability on outcome in patients referred for stress testing.

Background: There is limited insight into the association of electrocardiographic interpretability with outcome in patients referred for stress testing.

Methods: Exercise echocardiography was performed in 8226 patients with known or suspected coronary artery disease. Electrocardiograms were considered uninterpretable in the presence of left bundle-branch block (LBBB), left ventricular hypertrophy (LVH) with strain, repolarization abnormalities because of digitalis therapy, ventricular paced rhythm, preexcitation or ST depression ≥ 0.

Left atrial size and risk for all-cause mortality and ischemic stroke.

Background: Limited data are available on the relation between left atrial size and outcome among patients referred for clinically indicated echocardiograms. Our aim was to assess the association of left atrial size with all-cause mortality and ischemic stroke in a large cohort of patients referred for echocardiography.

Methods: Left atrial diameter was measured in 52 639 patients aged 18 years or older (mean age 61.

Value of exercise echocardiography for predicting mortality in elderly patients.

Background: Elderly patients with suspected or known coronary artery disease are often referred for pharmacological stress testing. Data on the value of exercise echocardiography (ExEcho) for predicting outcome (particularly all-cause mortality) in these patients are scarce.

Methods: Peak treadmill ExEcho was performed in 2159 patients ≥ 70 years of age with known or suspected coronary artery disease.

Prognostic value of exercise echocardiography in patients with left ventricular systolic dysfunction and known or suspected coronary artery disease.

Background: The prognostic value of exercise echocardiography (ExE) in patients with left ventricular systolic dysfunction (LVSD) has not been characterized. We sought to assess the value of ExE for predicting outcome in patients with LVSD and known/suspected coronary artery disease.

Methods: This study is a retrospective analysis of a prospectively collected database of 1,107 patients who underwent treadmill ExE and had resting LVSD (left ventricular ejection fraction <50%).

Effect of atrial fibrillation on outcome in patients with known or suspected coronary artery disease referred for exercise stress testing.

The association of atrial fibrillation (AF) with coronary artery disease (CAD) remains controversial. In addition, the relation of AF to myocardial ischemia and outcomes in patients with known or suspected CAD referred for exercise stress testing has been poorly explored. In this study, 17,100 patients aged > or = 50 years with known or suspected CAD who underwent exercise electrocardiography (n = 11,911) or exercise echocardiography (n = 5,189) were evaluated.

Prognostic value of an exaggerated exercise blood pressure response in patients with diabetes mellitus and known or suspected coronary artery disease.

The prognostic value of an exaggerated exercise systolic blood pressure response (EESBPR) remains controversial. Our aim was to assess whether an EESBPR is associated with the long-term outcome in patients with diabetes mellitus and known or suspected coronary artery disease (CAD). From an initial population of 22,262 patients with known or suspected CAD who underwent treadmill exercise electrocardiography or exercise echocardiography at our institution, 2,591 patients with a history of diabetes mellitus were selected for the present study.

Prognostic value of exercise echocardiography in patients with atrial fibrillation.

Aims: Non-invasive imaging techniques for the detection of coronary artery disease (CAD) may have technical problems in patients with atrial fibrillation (AF). Although the prognostic value of exercise echocardiography (ExEcho) has been well established in several subgroups of patients, it has not yet been specifically evaluated in these patients.

Methods And Results: From a population of 8095 patients with known or suspected CAD referred for ExEcho, 419 had AF at the time of the tests.

Prognostic value of peak and post-exercise treadmill exercise echocardiography in patients with known or suspected coronary artery disease.

Aims: Although peak may have higher sensitivity than post-treadmill exercise echocardiography (EE) for the detection of coronary artery disease (CAD), its prognostic value remains unknown. We sought to assess the relative values of peak and post-EE for predicting outcome in patients with known/suspected CAD.

Methods And Results: We studied 2947 patients who underwent EE.

Prediction of mortality and major cardiac events by exercise echocardiography in patients with normal exercise electrocardiographic testing.

Objectives: We sought to assess the value of exercise echocardiography (EE) for predicting outcome in patients with known or suspected coronary artery disease and normal exercise electrocardiogram (ECG) testing.

Background: The prognostic value of EE in patients with normal exercise ECG testing has not been characterized.

Methods: We studied 4,004 consecutive patients (2,358 men, mean age [+/- SD] 59.

Prognostic value of exercise echocardiography in patients with left bundle branch block.

Objectives: Our aim was to evaluate the role of exercise echocardiography for predicting outcome in a cohort of patients with left bundle branch block (LBBB).

Background: Although the prognostic value of exercise echocardiography has been well established in several subgroups of patients, it has not been specifically assessed in patients with LBBB.

Methods: Of the 8,050 patients who underwent treadmill exercise echocardiography, 618 demonstrated complete LBBB.