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Independent contribution of myocardial perfusion defects to exercise capacity and heart rate recovery for prediction of all-cause mortality in patients with known or suspected coronary heart disease

Lazaro A. Diaz, MD^*, Richard C. Brunken, MD, FACC, Eugene H. Blackstone, MD, FACC , Claire E. Snader, MA^* and Michael S. Lauer, MD, FACC^*

^* Department of Cardiology, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Cardiothoracic Surgery, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Epidemiology and Biostatistics, the Cleveland Clinic Foundation, Cleveland, Ohio, USA
Department of Nuclear Medicine, the Cleveland Clinic Foundation, Cleveland, Ohio, USA

View larger version (29K): [in a new window]   Figure 1 Seven-year mortality according to exercise test findings and composite prognostic nuclear score among patients without a history of prior revascularization. On the horizontal axis, "None" refers to patients with at least average physical fitness and normal heart rate recovery; "One" refers to patients with impaired physical fitness or abnormal heart rate recovery, but not both; and "Two" refers to patients with both impaired physical fitness and an abnormal heart rate recovery. The numbers underneath each of the bars refers to the number of deaths (numerator) and the total number of patients (denominator) in each subgroup.

View larger version (29K): [in a new window]   Figure 2 Seven-year mortality according to exercise test findings and composite prognostic nuclear score among patients with a history of prior coronary artery bypass grafting. Horizontal axis labeling is the same as in Figure 1.

View larger version (28K): [in a new window]   Figure 3 Seven-year mortality according to exercise testing findings and composite prognostic nuclear score among patients with a history of prior percutaneous coronary interventions, but no history of prior coronary bypass grafting. Horizontal axis labeling is the same as in Figure 1.

View larger version (19K): [in a new window]   Figure 4 Survival according to thallium201 single photon emission computed tomography findings after adjustments for covariates. Patients were classified as having normal scans or scans with intermediate- or high-risk findings based on the composite prognostic nuclear score discussed in detail in the text. Dotted lines indicate 95% confidence limits.