| Title: |
Long-term prognostic value of contemporary stress echocardiography in patients with suspected or known coronary artery disease: systematic review and meta-analysis |
| Authors: |
Ihekwaba, U; Johnson, N; Choi, JS; Savarese, G; Orsini, N; Khoo, J; Squire, I; Kardos, A |
| Publisher Information: |
BMJ Publishing Group |
| Publication Year: |
2025 |
| Collection: |
Oxford University Research Archive (ORA) |
| Description: |
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. PROSPERO registration number: CRD42023416766. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1136/heartjnl-2024-324534 |
| Availability: |
https://doi.org/10.1136/heartjnl-2024-324534; https://ora.ox.ac.uk/objects/uuid:72770a51-32cd-472e-8c17-7b5eb22ffefd |
| Rights: |
info:eu-repo/semantics/openAccess ; CC Attribution-NonCommercial (CC BY-NC) |
| Accession Number: |
edsbas.D6D2B1DB |
| Database: |
BASE |