"VSports app下载" Prognostic significance of dyspnea in patients referred for cardiac stress testing
- PMID: 16267320
- DOI: "VSports手机版" 10.1056/NEJMoa042741
Prognostic significance of dyspnea in patients referred for cardiac stress testing
Abstract
Background: Although dyspnea is a common symptom, there has been only limited investigation of its prognostic significance among patients referred for cardiac evaluation. VSports手机版.
Methods: We studied 17,991 patients undergoing myocardial-perfusion single-photon-emission computed tomography during stress and at rest V体育安卓版. Patients were divided into five categories on the basis of symptoms at presentation (none, nonanginal chest pain, atypical angina, typical angina, and dyspnea). Multivariable analysis was used to assess the incremental prognostic value of symptom categories in predicting the risk of death from cardiac causes and from any cause. In addition, the prognosis associated with various symptoms at presentation was compared in subgroups selected on the basis of propensity analysis. .
Results: After a mean (+/-SD) follow-up of 2. 7+/-1. 7 years, the rate of death from cardiac causes and from any cause was significantly higher among patients with dyspnea (both those previously known to have coronary artery disease and those with no known history of coronary artery disease) than among patients with other or no symptoms at presentation. Among patients with no known history of coronary artery disease, those with dyspnea had four times the risk of sudden death from cardiac causes of asymptomatic patients and more than twice the risk of patients with typical angina. Dyspnea was associated with a significant increase in the risk of death among each clinically relevant subgroup and remained an independent predictor of the risk of death from cardiac causes (P<0. 001) and from any cause (P<0. 001) after adjustment for other significant factors by multivariable and propensity analysis. V体育ios版.
Conclusions: In a large series of patients, self-reported dyspnea identified a subgroup of otherwise asymptomatic patients at increased risk for death from cardiac causes and from any cause. Our results suggest that an assessment of dyspnea should be incorporated into the clinical evaluation of patients referred for cardiac stress testing VSports最新版本. .
Copyright 2005 Massachusetts Medical Society V体育平台登录. .
Comment in
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Dyspnea and risk in suspected coronary disease.N Engl J Med. 2005 Nov 3;353(18):1963-5. doi: 10.1056/NEJMe058192. N Engl J Med. 2005. PMID: 16267328 No abstract available.
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Dyspnea and stress testing.N Engl J Med. 2006 Feb 23;354(8):871-3; author reply 871-3. doi: 10.1056/NEJMc053319. N Engl J Med. 2006. PMID: 16495402 No abstract available.
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Dyspnea and stress testing.N Engl J Med. 2006 Feb 23;354(8):871-3; author reply 871-3. N Engl J Med. 2006. PMID: 16498719 No abstract available.
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Dyspnea and stress testing. (V体育官网)N Engl J Med. 2006 Feb 23;354(8):871-3; author reply 871-3. N Engl J Med. 2006. PMID: 16498720 No abstract available.
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Dyspnea and stress testing.N Engl J Med. 2006 Feb 23;354(8):871-3; author reply 871-3. N Engl J Med. 2006. PMID: 16498721 No abstract available.
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Dyspnea and stress testing.N Engl J Med. 2006 Feb 23;354(8):871-3; author reply 871-3. N Engl J Med. 2006. PMID: 16498722 No abstract available.
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Dyspnoea at cardiac stress testing was associated with an increased risk of death in symptomatic and asymptomatic people. (VSports)Evid Based Med. 2006 Jun;11(3):91. doi: 10.1136/ebm.11.3.91. Evid Based Med. 2006. PMID: 17213112 No abstract available.
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