ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology
Symptom-limited exercise combined with dipyridamole stress: prognostic value in assessment of known or suspected coronary artery disease by use of gated SPECT imaging.
Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01021618 (The Ex-Lex Trial), which is not on this map. Cited by 12 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Ex-Lex Trial: A Randomized Trial Combining Regadenoson With Symptom-Limited Exercise in Patients Undergoing Myocardial Perfusion Imaging
Who cites it
12 citing papers in PubMed.
- The EXXERT Study.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Trial
- The EXERRT trial: "EXErcise to Regadenoson in Recovery Trial": A phase 3b, open-label, parallel group, randomized, multicenter study to assess regadenoson administration following an inadequate exercise stress test as compared to regadenoson without exercise for myocardial perfusion imaging using a SPECT protocol.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2017Trial
- Regadenoson pharmacologic stress for myocardial perfusion imaging: a three-way comparison between regadenoson administered at peak exercise, during walk recovery, or no-exercise.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2013Trial
- Differences in Clinical Characteristics, Results and Management of Patients Referred for Pharmacologic Cardiac Stress SPECT Depending on the Protocol Used.European cardiology · 2017Article
- Very high coronary artery calcium score with normal myocardial perfusion SPECT imaging is associated with a moderate incidence of severe coronary artery disease.European journal of nuclear medicine and molecular imaging · 2015Article
- New exercise-dipyridamole combined test for nuclear cardiology in insufficient effort: appropriate diagnostic sensitivity keeping exercise prognosis.Arquivos brasileiros de cardiologia · 2015Article
- Does risk for major adverse cardiac events in patients undergoing vasodilator stress with adjunctive exercise differ from patients undergoing either standard exercise or vasodilator stress with myocardial perfusion imaging?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2015Article
- Cardiovascular risk stratification in diabetic patients following stress single-photon emission-computed tomography myocardial perfusion imaging: the impact of achieved exercise level.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Article
- Prognosis of normal stress-only gated-SPECT myocardial perfusion imaging: a single center study.The international journal of cardiovascular imaging · 2013Article
- Advanced hybrid stress testing: a potential new paradigm combining exercise and pharmacologic stress.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2012Article
- Patient preparation for nuclear imaging: when should anti-ischemic medications be withheld?Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
- Symptom-limited exercise during vasodilator stress: best of both worlds?Journal of nuclear cardiology : official publication of the American Society of Nuclear CardiologyArticle
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCombining vasodilator and exercise stress reduces noncardiac side effects, improves image quality, and enhances the detection of ischemia, compared with suboptimal exercise or vasodilator stress alone. However, prognostic data with combined protocols are limited. METHODS AND
resultsConsecutive patients (n = 2064) who underwent symptom-limited exercise and dipyridamole stress with gated single-photon emission computed tomography (SPECT) imaging, without early revascularization, were studied. Subsequent cardiac death or nonfatal myocardial infarction was related to exercise and gated SPECT variables. Cox proportional hazards regression modeling was performed to identify predictors of adverse outcome. Annualized event rates in patients with normal and abnormal images were 0.96% and 2.71%, respectively (P < .001). With abnormal imaging, annualized event rates were 0.86% and 3.13% in patients with average to high and fair or poor functional capacity, respectively (P = .019). Abnormal imaging, a severely reduced post-stress ejection fraction, transient ischemic dilation, and fair or poor functional capacity emerged as predictors of adverse outcome. Accordingly, patients were stratified into low-risk, intermediate-risk, and high-risk cohorts with annualized event rates of 0.94%, 2.24%, and 8.19%, respectively (P < .001 in any two-way comparison).
conclusionsA protocol that combines symptom-limited exercise and dipyridamole stress with gated SPECT imaging provides highly effective risk stratification for adverse outcomes.
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Registered trials
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