CLINICAL STUDY: STRESS TESTING
The exercise test that indicates a low risk of events
Differences in prognostic significance between patients with chronic stable angina and patients with unstable angina
Rafael Florenciano-Sánchez, MDa,*,
Juan A. Castillo-Moreno, MBa,
Eduardo Molina-Laborda, MBa,
Manuel Jiménez-Pascual, MBa,
Pedro García-Urruticoechea, MBa,
Santiago Egea-Beneyto, MBa,
José G. Sánchez-Villanueva, MBa and
Juan Ortega-Bernal, MBa
a Cardiology Unit, Hospital Santa María del Rosell, Murcia, Spain
Manuscript received March 7, 2001;
revised manuscript received August 6, 2001,
accepted August 24, 2001.
* Reprint requests and correspondence: Dr. Rafael Florenciano, Historiador Torres Fontes,18; 4° E, 30011 Murcia, Spain. r.florenciano{at}retemail.es
OBJECTIVES: The objective of this prospective study was to determine the differences in the prognostic significance of an exercise test (ET) that indicates a low risk of events (low-risk exercise test [LRET]) between patients with unstable angina (UA) and those with chronic stable angina (CSA).
BACKGROUND: It is not known whether the prognostic significance of an LRET is influenced by the disease; that is the reason for performing exercise testing.
METHODS: All patients not presenting with high-risk criteria were submitted to a prognostic ET. The ET was performed by patients with CSA and patients with primary UA stabilized with medical therapy. Medical therapy was planned for all patients. A combined end point was defined as cardiac death, nonfatal acute myocardial infarction or hospital admission for UA. Multivariate analysis was performed to determine the independent predictors of events.
RESULTS: Low-risk criteria were fulfilled by 105 patients with UA and 86 patients with CSA. The mean follow-up time was 347 ± 229 days. The event rate was higher in the UA group than in the CSA group (28% vs. 9%, p = 0.001). The CSA group showed worse ET results. Performance of ET by patients with UA was the principal predictor of events (odds ratio 4.2, p = 0.0005).
CONCLUSIONS: Among patients who underwent an LRET, those with UA had a rate of events significantly higher than that of patients with CSA, despite the worse results of ET in patients with CSA.
|
Abbreviations and Acronyms
| | CSA | | chronic stable angina | | ECG | | electrocardiogram or electrocardiographic | | ET | | exercise test(ing) | | LRET | | low-risk exercise test | | UA | | unstable angina |
|
This article has been cited by other articles:

|
 |

|
 |
 
R. Moreno, A. Villate, J. Zamorano, C. Almeria, J.-A. Perez-Gonzalez, J.-L. Rodrigo, L. P. de Isla, L. Mataix, and C. Macaya
Identifying patients without favourable long-term outcome among those with medically stabilized unstable angina and a negative dipyridamole stress echocardiogram
Eur J Echocardiogr,
June 1, 2004;
5(3):
205 - 211.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
A. Prasad, V. Mathew, D. R Holmes Jr., and B. J Gersh
Current management of non-ST-segment-elevation acute coronary syndrome: reconciling the results of randomized controlled trials
Eur. Heart J.,
September 1, 2003;
24(17):
1544 - 1553.
[Abstract]
[Full Text]
[PDF]
|
 |
|

|
 |

|
 |
 
Unstable Angina Portends Higher Mortality Despite Low-Risk Exercise Tolerance Test
Journal Watch Emergency Medicine,
February 27, 2002;
2002(227):
3 - 3.
[Full Text]
|
 |
|
|