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

https://doi.org/10.1136/ebm.11.3.91

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    Abidov A, Rozanski A, Hachamovitch R, et al. Prognostic significance of dyspnea in patients referred for cardiac stress testing. N Engl J Med 2005;353:1889–98.
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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 ★★★★★★☆

    METHODS

    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.

    MAIN RESULTS

    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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    Footnotes

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

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