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• W1971521100 abstract "Objectives. This study evaluated the prognostic value of abnormal test results with pharmacologic stress with regard to perioperative and long-term outcomes in a large population of candidates for vascular surgery. Background. Although numerous studies have demonstrated the prognostic value of dipyridamole-thallium-201 myocardial perfusion and dobutamine echocardiography in vascular surgery candidates, a synopsis of predictive estimates is different because of individual study variability in pretest clinical risk, sample size and study design. Methods. A systematic review of published reports on preoperative pharmacologic stress risk stratification from the MEDLINE data base (1985 to 1994) identified 10 reports on dipyridamole-thallium-201 myocardial perfusion (1,994 patients) and 5 on dobutamine stress echocardiography (445 patients). Random effects models were used to calculate summary odds ratios and 95% confidence intervals. Results. Summary odds ratios for death or myocardial infarction and secondary cardiac end points were greater for dobutamine echocardiographic dysynergy (14- to 27-fold) than for dipyridamole-thallium-201 redistribution (4-fold); wider confidence intervals were noted with dobutamine echocardiography. Pretest coronary disease probability was correlated with the positive predictive value of a reversible thallium-201 defect (r = 0.70). Increasing sixfold from low to high risk patients subsets. Cardiac event rates were low in patients without a history of coronary artery disease (1% in 176 patients) compared with patients with coronary disease and a normal or fixed-defect pattern (4.8% in 83 patients) and one or more thallium-201 redistribution abnormality (18.6% in 97 patients, p = 0.0001). Conclusions. Meta-analysis of 15 studies demonstrated that the prognostic value of noninvasive stress imaging abnormalities for perioperative ischemic events is comparable between available t techniques but that the accuracy varies with coronary artery disease prevalence." @default.
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• W1971521100 date "1996-03-01" @default.
• W1971521100 modified "2023-10-18" @default.
• W1971521100 title "Meta-analysis of intravenous dipyridamole-thallium-201 imaging (1985 to 1994) and dobutamine echocardiography (1991 to 1994) for risk stratification before vascular surgery" @default.
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• W1971521100 doi "https://doi.org/10.1016/0735-1097(95)00549-8" @default.
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