Ugochukwu Ihekwaba, Nicholas Johnson, Ji Soo Choi, Gianluigi Savarese, Nicola Orsini, Jeffrey Khoo, Iain Squire, Attila Kardos
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The primary outcome was a composite of all-cause mortality or cardiovascular death and non-fatal myocardial infarction, depending on the definition applied in individual trials, termed as major adverse cardiovascular event (MACE). Secondary outcome was all-cause mortality. Positive stress echocardiography result was defined as inducible ischaemia in at least one of the 17 left ventricular segments and negative stress echocardiography with no inducible ischaemia.</p><p><strong>Results: </strong>Among a total of six trials, 16 581 subjects underwent either pharmacological or treadmill stress echocardiography, a median follow-up of 31 months (range 21-101). The annual event rate was 1.76% for the composite MACE and 1.35% for all-cause mortality. Compared with negative stress echocardiography, positive stress echocardiography was associated with an increased risk of the MACE and all-cause mortality with an annual event rate of 1.99% vs 1.54% (OR 2.04, 95% CI 1.79 to 2.33) and 1.68% vs 1.02% (OR 2.06, 95% CI 1.80 to 2.35), respectively.</p><p><strong>Conclusion: </strong>Positive stress echocardiography results were associated with poorer long-term MACE and all-cause mortality. Stress echocardiography results may provide a useful long-term guidance in intensifying preventative treatment in patients with suspected coronary artery disease.</p><p><strong>Prospero registration number: </strong>CRD42023416766.</p>","PeriodicalId":12835,"journal":{"name":"Heart","volume":null,"pages":null},"PeriodicalIF":5.1000,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Long-term prognostic value of contemporary stress echocardiography in patients with suspected or known coronary artery disease: systematic review and meta-analysis.\",\"authors\":\"Ugochukwu Ihekwaba, Nicholas Johnson, Ji Soo Choi, Gianluigi Savarese, Nicola Orsini, Jeffrey Khoo, Iain Squire, Attila Kardos\",\"doi\":\"10.1136/heartjnl-2024-324534\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Long-term outcome of contemporary stress echocardiography has not been systematically assessed.</p><p><strong>Objective: </strong>To evaluate the association between results of stress echocardiography and patients' outcomes with suspected coronary artery disease using randomised controlled trials.</p><p><strong>Methods: </strong>Multiple electronic databases were searched for studies evaluating long-term outcome (>12 months) of stress echocardiography in patients suspected of coronary artery disease since year 2000. 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引用次数: 0
摘要
背景：现代负荷超声心动图的长期结果尚未得到系统评估：现代负荷超声心动图的长期结果尚未得到系统评估：通过随机对照试验评估负荷超声心动图检查结果与疑似冠心病患者预后之间的关系：方法：在多个电子数据库中搜索自 2000 年以来对疑似冠状动脉疾病患者进行负荷超声心动图检查的长期结果（大于 12 个月）进行评估的研究。采用共同效应模型得出集合估计值。主要结果是全因死亡率或心血管死亡和非致死性心肌梗死的复合结果，具体取决于各试验采用的定义，称为主要不良心血管事件（MACE）。次要结果为全因死亡率。应激超声心动图阳性结果的定义是，17个左心室节段中至少有一个节段存在诱发性缺血，而应激超声心动图阴性结果则不存在诱发性缺血：在总共六项试验中，16 581 名受试者接受了药物或跑步机负荷超声心动图检查，中位随访时间为 31 个月（21-101 个月）。复合 MACE 年发生率为 1.76%，全因死亡率为 1.35%。与阴性负荷超声心动图相比，阳性负荷超声心动图与MACE和全因死亡率风险增加有关，年事件发生率分别为1.99% vs 1.54% (OR 2.04, 95% CI 1.79 to 2.33)和1.68% vs 1.02% (OR 2.06, 95% CI 1.80 to 2.35)：结论：负荷超声心动图阳性结果与较差的长期MACE和全因死亡率相关。压力超声心动图结果可为疑似冠心病患者加强预防性治疗提供长期有用的指导：CRD42023416766。
Long-term prognostic value of contemporary stress echocardiography in patients with suspected or known coronary artery disease: systematic review and meta-analysis.
Background: Long-term outcome of contemporary stress echocardiography has not been systematically assessed.
Objective: To evaluate the association between results of stress echocardiography and patients' outcomes with suspected coronary artery disease using randomised controlled trials.
Methods: Multiple electronic databases were searched for studies evaluating long-term outcome (>12 months) of stress echocardiography in patients suspected of coronary artery disease since year 2000. A common-effect model was used to derive pooled estimates. The primary outcome was a composite of all-cause mortality or cardiovascular death and non-fatal myocardial infarction, depending on the definition applied in individual trials, termed as major adverse cardiovascular event (MACE). Secondary outcome was all-cause mortality. Positive stress echocardiography result was defined as inducible ischaemia in at least one of the 17 left ventricular segments and negative stress echocardiography with no inducible ischaemia.
Results: Among a total of six trials, 16 581 subjects underwent either pharmacological or treadmill stress echocardiography, a median follow-up of 31 months (range 21-101). The annual event rate was 1.76% for the composite MACE and 1.35% for all-cause mortality. Compared with negative stress echocardiography, positive stress echocardiography was associated with an increased risk of the MACE and all-cause mortality with an annual event rate of 1.99% vs 1.54% (OR 2.04, 95% CI 1.79 to 2.33) and 1.68% vs 1.02% (OR 2.06, 95% CI 1.80 to 2.35), respectively.
Conclusion: Positive stress echocardiography results were associated with poorer long-term MACE and all-cause mortality. Stress echocardiography results may provide a useful long-term guidance in intensifying preventative treatment in patients with suspected coronary artery disease.
期刊介绍：
Heart is an international peer reviewed journal that keeps cardiologists up to date with important research advances in cardiovascular disease. New scientific developments are highlighted in editorials and put in context with concise review articles. There is one free Editor’s Choice article in each issue, with open access options available to authors for all articles. Education in Heart articles provide a comprehensive, continuously updated, cardiology curriculum.
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