Evidence map›Paper›PMID 23539339›Full record

Observational studyEuropean heart journal2013

Value of reserve pulse pressure in improving the risk stratification of patients with normal myocardial perfusion imaging.

Deepak Thomas, Mouaz Al-Mallah, Usha Govindarajulu, Daniel E Forman, Samia Mora, Marcelo F Di Carli, Sharmila Dorbala

Abstract readEvaluation StudyObservational Study
In one paragraph

Observational study in European heart journal, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors.

Deepak ThomasThe Noninvasive Cardiovascular Imaging Program, Department of Medicine (Cardiology), Brigham and Women's Hospital, Boston, MA 02115, USA.
Mouaz Al-Mallah
Usha Govindarajulu
Daniel E Forman
Samia Mora
Marcelo F Di Carli
Sharmila Dorbala

Funding

Prognostic Utility of Absolute Coronary Microvascular Function by PET/CTK23HL092299 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI DORBALA, SHARMILA · 2009 to 2013
$705k
NHLBI NIH HHS 5K23HL92299-3NHLBI NIH HHS K23HL092299
6 · The paper itself

Abstract

aimsTo evaluate the incremental prognostic value of reserve-pulse pressure (reserve-PP: exercise-PP minus rest-PP) to standard risk factors among patients with suspected coronary artery disease (CAD) but normal exercise myocardial perfusion imaging (MPI). METHODS AND

resultsWe studied 4269 consecutive symptomatic patients without known CAD who were referred for exercise MPI but had normal MPI results (mean age 58 ± 12 years, 56% females, 84% referred for evaluation of chest pain or dyspnoea, 95% with intermediate pretest likelihood of CAD). There were 202 deaths over 5.1 ± 1.4 years of follow-up. Reserve-PP was abnormal (<44 mmHg increase in PP from rest) in 1894 patients (44%). Patients with an abnormal reserve-PP had a higher risk of death compared with patients with normal reserve-PP [hazard ratio (HR): 2.47, 95% CI, 1.8-3.3]. In multivariable models adjusting for age, sex, ejection fraction, medications, heart rate recovery, Duke treadmill score (DTS), and rest-PP, each 10 mmHg lower reserve-PP was associated with a 20.6% increase in risk-adjusted mortality (adjusted HR 0.83, 95% CI 0.76-0.91). Models incorporating reserve-PP significantly reclassified risk compared with models without these parameters (net reclassification index 14.3%, P = 0.0007; integrated discrimination index 0.69, P = 0.01).

conclusionIn patients without a history of CAD and a normal MPI, an abnormal reserve-PP identified and reclassified those at higher risk of death independent of known risk factors and DTS.

Indexed as

Blood PressureCohort StudiesCoronary Artery DiseaseExerciseExercise TestFemaleHemodynamicsHumansMaleMiddle AgedMyocardial Perfusion ImagingPrognosisPulseRisk AssessmentMyocardial perfusion imagingNormalPrognosisPulse pressureSPECT

Identifiers

PMID23539339
PMCPMC3710579

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.