Assessment of cardiac risk before nonvascular surgery: Dobutamine stress echocardiography in 530 patients

摘要: Abstract OBJECTIVE This study evaluated the incremental value of dobutamine stress echocardiography (DSE) for assessment cardiac risk before nonvascular surgery. BACKGROUND Limited information exists regarding preoperative in patients with known or suspected coronary artery disease who are to undergo METHODS All (303 men, 227 women) underwent DSE surgery and did not sustain an intervening event (coronary revascularization event) were studied. Clinical, electrocardiographic rest echocardiographic variables identify predictors postoperative events. RESULTS Events occurred 6% patients: 1 death 31 nonfatal myocardial infarctions. these had inducible ischemia on (sensitivity 100%, specificity 63%). Multivariate events history congestive heart failure (p = 0.006; odds ratio 4.66; confidence interval 1.55 14.02) ischemic threshold less than 60% age-predicted maximal rate 0.0001; 7.002; 2.79 17.61). Clinical Eagle’s index identified 21% as low, 68% intermediate 11% high preoperatively; rates 3%, 14%, respectively. Dobutamine low (no ischemia), 32% (ischemic more) 8% CONCLUSIONS In this population surgery, over clinical, identifying at Ischemia occurring highest risk.