The exercise test that indicates a low risk of events. Differences in prognostic significance between patients with chronic stable angina and patients with unstable angina

J Am Coll Cardiol. 2001 Dec;38(7):1974-9. doi: 10.1016/s0735-1097(01)01674-6.

Abstract

Objectives: The objective of this prospective study was to determine the differences in the prognostic significance of an exercise test (ET) that indicates a low risk of events (low-risk exercise test [LRET]) between patients with unstable angina (UA) and those with chronic stable angina (CSA).

Background: It is not known whether the prognostic significance of an LRET is influenced by the disease; that is the reason for performing exercise testing.

Methods: All patients not presenting with high-risk criteria were submitted to a prognostic ET. The ET was performed by patients with CSA and patients with primary UA stabilized with medical therapy. Medical therapy was planned for all patients. A combined end point was defined as cardiac death, nonfatal acute myocardial infarction or hospital admission for UA. Multivariate analysis was performed to determine the independent predictors of events.

Results: Low-risk criteria were fulfilled by 105 patients with UA and 86 patients with CSA. The mean follow-up time was 347 +/- 229 days. The event rate was higher in the UA group than in the CSA group (28% vs. 9%, p = 0.001). The CSA group showed worse ET results. Performance of ET by patients with UA was the principal predictor of events (odds ratio 4.2, p = 0.0005).

Conclusions: Among patients who underwent an LRET, those with UA had a rate of events significantly higher than that of patients with CSA, despite the worse results of ET in patients with CSA.

MeSH terms

  • Aged
  • Angina Pectoris / diagnosis*
  • Angina Pectoris / mortality
  • Angina Pectoris / physiopathology
  • Angina, Unstable / diagnosis*
  • Angina, Unstable / mortality
  • Angina, Unstable / physiopathology
  • Cause of Death
  • Chronic Disease
  • Electrocardiography*
  • Exercise Test*
  • Female
  • Heart Conduction System / physiopathology
  • Hemodynamics / physiology
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / mortality
  • Myocardial Infarction / physiopathology
  • Patient Admission / statistics & numerical data
  • Prognosis
  • Risk Assessment
  • Survival Rate