Which stress test is superior for perioperative cardiac risk stratification in patients undergoing major vascular surgery?

M. Kertai, E. Boersma, R. Sicari, G. J. L'Italien, J. J. Bax, J. R T C Roelandt, H. Van Urk, D. Poldermans

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Objective: To compare the additional prognostic value of Dobutamine Stress Echocardiography (DSE), Dipyridamole Stress Echocardiography (DiSE) and Perfusion Scintigraphy (DTS) on clinical risk factors in patients undergoing major vascular surgery. Design: retrospective analysis. Materials: 2204 consecutive patients who underwent DSE (n = 1093), DiSE (n = 394), or DTS (n = 727) testing before major vascular surgery were studied. Methods: primary endpoint was a composite of cardiac death and non-fatal myocardial infarction (MI). Logistic regression analysis was performed to evaluate the relation between cardiac risk factors, stress test results and the incidence of the composite endpoint. Results: there were 138 patients (6.3%) with cardiac death or ML Patients with 0, 1-2, and 3 or more risk factors experienced respectively 3.0, 5.7 and 17.4% cardiac events. We found no statistically significant difference in the predictive value of a positive test result for DiSE and DSE (Odds ratio (OR) of 37.1 [95% CI, 8.1-170.1] vs 9.6 [95% CI, 4.9-18.4]; p = 0.22), whereas a positive test result for DTS had significantly lower prognostic value (OR = 1.95 [95% CI, 1.2-3.2]). Conclusion: a result of stress echocardiography effectively stratified patients into low- and high-risk groups for cardiac complications, irrespective of clinical risk profile. In contrast, the prognostic value of DTS results was more likely to be dependent on patients' clinical risk profile.

Original languageEnglish
Pages (from-to)222-229
Number of pages8
JournalEuropean Journal of Vascular and Endovascular Surgery
Volume24
Issue number3
DOIs
Publication statusPublished - Sep 2002

Fingerprint

Stress Echocardiography
Exercise Test
Blood Vessels
Dipyridamole
Odds Ratio
Perfusion Imaging
Logistic Models
Myocardial Infarction
Regression Analysis
Incidence

Keywords

  • Dipyridamole perfusion scintigraphy
  • Dipyridamole stress echocardiography
  • Dobutamine stress echocardiography
  • Major vascular surgery
  • Prognosis
  • Risk assessment

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging
  • Surgery

Cite this

Which stress test is superior for perioperative cardiac risk stratification in patients undergoing major vascular surgery? / Kertai, M.; Boersma, E.; Sicari, R.; L'Italien, G. J.; Bax, J. J.; Roelandt, J. R T C; Van Urk, H.; Poldermans, D.

In: European Journal of Vascular and Endovascular Surgery, Vol. 24, No. 3, 09.2002, p. 222-229.

Research output: Contribution to journalArticle

Kertai, M. ; Boersma, E. ; Sicari, R. ; L'Italien, G. J. ; Bax, J. J. ; Roelandt, J. R T C ; Van Urk, H. ; Poldermans, D. / Which stress test is superior for perioperative cardiac risk stratification in patients undergoing major vascular surgery?. In: European Journal of Vascular and Endovascular Surgery. 2002 ; Vol. 24, No. 3. pp. 222-229.
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abstract = "Objective: To compare the additional prognostic value of Dobutamine Stress Echocardiography (DSE), Dipyridamole Stress Echocardiography (DiSE) and Perfusion Scintigraphy (DTS) on clinical risk factors in patients undergoing major vascular surgery. Design: retrospective analysis. Materials: 2204 consecutive patients who underwent DSE (n = 1093), DiSE (n = 394), or DTS (n = 727) testing before major vascular surgery were studied. Methods: primary endpoint was a composite of cardiac death and non-fatal myocardial infarction (MI). Logistic regression analysis was performed to evaluate the relation between cardiac risk factors, stress test results and the incidence of the composite endpoint. Results: there were 138 patients (6.3{\%}) with cardiac death or ML Patients with 0, 1-2, and 3 or more risk factors experienced respectively 3.0, 5.7 and 17.4{\%} cardiac events. We found no statistically significant difference in the predictive value of a positive test result for DiSE and DSE (Odds ratio (OR) of 37.1 [95{\%} CI, 8.1-170.1] vs 9.6 [95{\%} CI, 4.9-18.4]; p = 0.22), whereas a positive test result for DTS had significantly lower prognostic value (OR = 1.95 [95{\%} CI, 1.2-3.2]). Conclusion: a result of stress echocardiography effectively stratified patients into low- and high-risk groups for cardiac complications, irrespective of clinical risk profile. In contrast, the prognostic value of DTS results was more likely to be dependent on patients' clinical risk profile.",
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AU - Boersma, E.

AU - Sicari, R.

AU - L'Italien, G. J.

AU - Bax, J. J.

AU - Roelandt, J. R T C

AU - Van Urk, H.

AU - Poldermans, D.

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KW - Prognosis

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