Identifying patients without favourable long-term outcome among those with medically stabilized unstable angina and a negative dipyridamole stress echocardiogram.

Aims: Patients with medically stabilized unstable angina and a negative stress echocardiogram have a favourable outcome as a whole. This study sought to identify which subsets of patients are associated with serious events at long-term within this population.

Methods And Results: We studied and followed-up 128 patients (mean 2.2 +/- 1.3 years) with medically stabilized unstable angina and a negative dipyridamole stress echocardiogram. Cumulative survival rates were 98.2 +/- 1.3%, 96.0 +/- 2.2% and 93.2 +/- 3.2%, at 1, 2 and 4 years, respectively. Freedom from events (death, myocardial infarction, and revascularization) were 98.2 +/- 1.3%, 96.0 +/- 2.2% and 86.3 +/- 6.0%, at 1, 2, and 4 years, respectively. Cumulative mortality rate was higher in men (3.6 +/- 2.5%, 8.5 +/- 4.1%, and 12.2 +/- 5.4% at 1, 2, and 4 years, vs. 0% at the end of the follow-up in women; p = 0.034), and in those with previous myocardial infarction (4.3 +/- 4.3%, 9.1 +/- 6.2%, and 18.2 +/- 2.3% at 1, 2 and 4 years, vs. 1.1 +/- 1.1%, 2.9 +/- 2.1%, and 2.9 +/- 2.1% in those without previous myocardial infarction, respectively; p = 0.047).

Conclusion: Among patients with medically stabilized unstable angina and a negative dipyridamole stress echocardiogram, male gender and previous myocardial infarction are associated with a non-favourable outcome.