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Prognostic Utility of Stress Testing and Cardiac Biomarkers in Menopausal Women at Low to Intermediate Risk for Coronary ARTery Disease (SMART Study): 5-Year Outcome
- Source :
- Journal of women's health (2002). 27(5)
- Publication Year :
- 2018
-
Abstract
- In women with low to intermediate risk of coronary artery disease (CAD), prognostic detection strategies have been controversial. We present the follow-up data of the SMART trial in peri/postmenopausal women at low to intermediate risk of CAD.To determine the value of contrast stress echocardiography (CSE), stress electrocardiogram (sECG), and serum biomarkers for prediction of cardiovascular events (CE) in peri/postmenopausal women at low to intermediate risk of CAD.From January 2004 to August 2007, 400 peri/postmenopausal women were prospectively enrolled. All women had detailed risk factor assessment, and underwent simultaneous CSE (DefinityA total of 366 women (54.4 ± 5.5 years, Framingham risk 6.5% ± 4.4%) completed simultaneous CSE and sECG. Forty-two (11.5%) had abnormal CSE, while sECG was abnormal in 22 (6%) women. Follow-up (4.4 ± 1.2 years) was available in 315/366 (86%) women (78% exercise-CSE, 22% dobutamine-CSE). In those who completed follow-up, CSE was abnormal in 33 women (10.5%) and sECG was abnormal in 21 (6.7%). In 33 women with abnormal CSE, sECG was abnormal in 7 (21.2%) and normal in 26 (79%), p = 0.0004. CE occurred in 27 (8.6%) women: 8 all-cause mortality, 2 nonfatal MI, 13 CP, and 4 REVASC. CE occurred in 21% versus 7% of women with abnormal versus normal CSE, p = 0.014 and 38% versus 6% of women with abnormal versus normal sECG, p 0.0001. Rest BNP was higher in women with CE versus those without (p = 0.018). Abnormal sECG and abnormal CSE were associated with CE, while only abnormal sECG was an independent predictor of CE (adjusted HR 10.3 [1.9-61.4], p = 0.007). Of the laboratory results, only BNP was associated with CE (adjusted HR 2.9 [1.1-7.3], p = 0.028).sECG and rest BNP were independent predictors of subsequent CE within 5 years in peri/postmenopausal women at low to intermediate risk of CAD.
- Subjects :
- Adult
Male
medicine.medical_specialty
Chest Pain
Cardiac biomarkers
Minnesota
Stress testing
Myocardial Infarction
Coronary Artery Disease
030204 cardiovascular system & hematology
Risk Assessment
Angina Pectoris
Body Mass Index
Coronary artery disease
Stress ECG
03 medical and health sciences
Electrocardiography
0302 clinical medicine
Risk Factors
Internal medicine
medicine
Stress Echocardiography
Humans
030212 general & internal medicine
Prospective Studies
Aged
Heart Failure
business.industry
Arizona
General Medicine
Middle Aged
medicine.disease
Prognosis
Contrast echocardiography
Cardiology
Exercise Test
Florida
Female
Menopause
business
Intermediate risk
Biomarkers
Echocardiography, Stress
Subjects
Details
- ISSN :
- 1931843X
- Volume :
- 27
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Journal of women's health (2002)
- Accession number :
- edsair.doi.dedup.....325f3fc00bc3418d66f327e8f365fd59