Short-term risk stratification with accelerated high-dose dipyridamole stress echocardiography: follow-up into 301 consecutive outpatients.

AIM: This study aimed to assess the short-term predictive value of a pharmacologic stress echocardiography test performed with accelerated high-dose dipyridamole (0.84 mg/kg over 6 minutes).

METHODS

In all, 301 patients (161 men, mean age 61.41 +/- 11.62 years) were scheduled for accelerated high-dose dipyridamole stress test. A total of 22 tests were interrupted prematurely because of side effects (overall feasibility 92.7%). The patients were followed up for nonfatal myocardial infarction, unstable angina, myocardial revascularization, and sudden death at first and third months and each 6 months (maximum 18 months).

RESULTS

A positive echocardiographic response was found in 25 patients. Six patients with negative stress test experienced events. Eight patients with positive stress test went to coronary revascularization procedure. Negative predictive value was 97.8%, positive predictive value was 32%, sensitivity was 57%, and specificity was 94%.

CONCLUSIONS

Risk stratification with accelerated high-dose dipyridamole stress echocardiography is effective. A negative test predicts favorable short-term cardiovascular prognosis.