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Dyspnoea at cardiac stress testing was associated with an increased risk of death in symptomatic and asymptomatic people

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 Q In patients referred for cardiac stress testing, is dyspnoea associated with an increased risk of death?

Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆


Embedded ImageDesign:

cohort study with mean 2.7 years’ follow up.

Embedded ImageSetting:

a medical centre in Los Angeles, California, USA.

Embedded ImagePatients:

17 991 patients (mean age 65 y, 59% men) without known cardiomyopathy or valvular disease who received myocardial-perfusion single-photon-emission computed tomography during stress and at rest.

Embedded ImageRisk factors:

dyspnoea. Patients were categorised as being asymptomatic or as having non-anginal chest pain, typical angina, atypical angina, or dyspnoea.

Embedded ImageOutcomes:

death from any cause and cardiac causes. Cause of death was assessed blindly by 2 cardiologists.


At mean 2.7 years, 786 patients without apparent coronary artery disease (CAD) died (224 from cardiac causes), and 720 patients with CAD died (347 from cardiac causes). …

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  • For correspondence: Dr D S Berman, Cedars-Sinai Medical Center, Los Angeles, CA, USA. bermand{at}

  • Sources of funding: Bristol-Myers Squibb Medical Imaging and Medtronic.