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Stress echocardiography safely classified more patients as low risk of serious CAD than exercise electrocardiography

Clinical impact ratings Internal medicine Cardiology

Key Words: angina (unstable) • echocardiography (stress) • electrocardiography • exercise test • costs and cost analysis

The first 150 words of the full text of this article appear below.

METHODS
Design: randomised controlled trial.

Allocation: unclear allocation concealment.^*

Blinding: unblinded.^*

Follow up period: median 8.7 months.

Setting: hospital in Harrow, Middlesex, UK.

Patients: 433 patients (mean age 61 y, 57% men) with suspected acute coronary syndrome, non-diagnostic ECG, negative cardiac troponin test result, and 2 risk factors for CAD. Patients with known CAD awaiting revascularisation were excluded.

Intervention: risk of CAD was determined by SEcho using either treadmill or pharmacological testing (n = 215) or ExECG (n = 218) (negative test = low risk, positive test = high risk, and inconclusive test = pretest risk as determined by the Thrombolysis in Myocardial Infarction [TIMI] risk score). The attending physician made management decisions based on the results of the stress tests.

Outcomes: composite cardiac end point (cardiac death, myocardial infarction, or coronary artery revascularisation), proportion of patients assigned to each risk stratum, use of additional diagnostic tests, and total cost of . . . [Full text of this article]

Paul A Heidenreich, MD, MS

VA Palo Alto, Stanford University, Palo Alto, California, USA