Independent and incremental prognostic value of tests performed in hierarchical order to evaluate patients with suspected coronary artery disease

Validation of models based on these tests

Stewart G. Pollock, Robert D. Abbott, Charles A. Boucher, George A. Beller, Sanjiv Kaul

Research output: Contribution to journalArticle

134 Citations (Scopus)

Abstract

Background. The additive prognostic value of tests done in a hierarchical order for the detection of coronary artery disease (CAD) is not always known. The principal goal of this study, therefore, was to assess the incremental prognostic value of data obtained in succession (clinical, exercise stress testing, 201Tl imaging, and coronary angiography) in patients with suspected CAD. A second goal was to develop models for determining prognosis based on results of these tests and to test the clinical validity of these models in unrelated patients. Methods and Results. Data from two groups of patients who had undergone such evaluation and had been followed for a mean of 4.4 years were analyzed. There were 204 patients from Massachusetts General Hospital (MGH) and 299 from the University of Virginia (UVA). There were 20 deaths and 21 nonfatal infarctions in the MGH group and 41 deaths and nine infarctions in the UVA group. Both univariate and multivariate Cox regression analyses were performed to assess the individual and incremental prognostic value of these tests. In both groups, 201Tl imaging provided significant additional prognostic information compared with clinical and exercise stress test data (p201Tl ratio had been analyzed, coronary angiography did not provide additional prognostic information. In this group of patients, the combination of clinical and exercise 201Tl variables provided greater prognostic information than the combination of clinical and angiographic data (p201Tl data alone (p

Original languageEnglish (US)
Pages (from-to)237-248
Number of pages12
JournalCirculation
Volume85
Issue number1
StatePublished - Jan 1992
Externally publishedYes

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Coronary Artery Disease
Coronary Angiography
Exercise Test
General Hospitals
Infarction
Exercise
Regression Analysis

Keywords

  • Tl
  • Angiography
  • Coronary artery disease
  • Exercise
  • Stress
  • Testing

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Independent and incremental prognostic value of tests performed in hierarchical order to evaluate patients with suspected coronary artery disease : Validation of models based on these tests. / Pollock, Stewart G.; Abbott, Robert D.; Boucher, Charles A.; Beller, George A.; Kaul, Sanjiv.

In: Circulation, Vol. 85, No. 1, 01.1992, p. 237-248.

Research output: Contribution to journalArticle

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