Prognostic value of pharmacological stress echocardiography in patients with known or suspected coronary artery disease
A prospective, large-scale, multicenter, head-to-head comparison between dipyridamole and dobutamine test
Alessandro Pingitore, MDa,
Eugenio Picano, MD, PhDa,
Albert Varga, MDb,
Guido Gigli, MDa,
Lauro Cortigiani, MDa,
Mario Previtali, MDa,
Giovanni Minardi, MDa,
Massimo Quarta Colosso, MDa,
Jorge Lowenstein, MDa,
Wilson Mathias, Jr., MDa,
Patrizia Landi, BSca on behalf of the Echo-Persantine International Cooperative (EPIC) and Echo-Dobutamine International Cooperative (EDIC) Study Groups
a CNR Institute of Clinical Physiology, Pisa, Italy
b Visiting Fellow from the Albert Szent-Györgyi University Medical School, Szeged, Hungary with a grant "Eötvös" of the Hungarian Government
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Figure 1 Kaplan-Meier survival curves event free of cardiac death in patients with negative and positive DIP. Survival is worse in patients with positive DIP. In patients with positive DIP, progressive worse survival is identified with positivity after atropine, high dose and low dose. DIP + low dose vs. DIP negative, p < 0.0001. Cardiac death (n = 18); follow-up 38 ± 21 months.
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Figure 2 Kaplan-Meier survival curves event free of cardiac death in patients with negative and positive DOB. In patients with positive DOB, progressive worse survival is identified with positivity after high dose and low dose, whereas patients with positivity after atropine have a survival comparable to, or even better than, patients with DOB negativity (p = NS among all groups). Cardiac death (n = 18); follow-up 38 ± 21 months.
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Figure 3 Kaplan-Meier survival curves event free of cardiac death in patients stratified according to the results of rest-stress WMSI variation during DIP (Delta DIP WMSI). The survival is progressively worse for larger variations on WMSI. Delta DIP WMSI > .37 vs. DIP negative, p < 0.0001; Delta DIP WMSI >.37 vs. DIP  .37, p < 0.004. Cardiac death (n = 18); follow-up 38 ± 21 months.
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Figure 4 Kaplan-Meier survival curves event free of cardiac death in patients stratified according to the results of rest-stress WMSI variation during DOB (Delta DOB WMSI). The survival is progressively worse for larger variations on WMSI. Delta DOB WMSI > .37 vs. DOB negative, p < 0.005. Cardiac death (n = 18); follow-up 38 ± 21 months.
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