Stress ECHO Effectively Stratifies CAD Risk in Patients With HIV

Abnormal SE, ischemia on SE independently predict cardiovascular events in patients with HIV

WEDNESDAY, July 13 (HealthDay News) -- Stress echocardiography (SE) can effectively stratify risk and offer prognostic value for patients with HIV at risk for cardiovascular events, according to a study published online July 12 in Circulation: Cardiovascular Imaging.

Omar Wever Pinzon, M.D., from Columbia University in New York City, and colleagues assessed the prognostic value of SE in 311 HIV-infected patients (average age, 52 years; average left ventricular ejection fraction, 54 percent), with known or suspected coronary artery disease who were referred for SE (56 percent dobutamine). A 16-segment model five-point scale was used to evaluate left ventricle wall motion, with a fixed (infarction), biphasic, or new (ischemia) wall motion abnormality on stress defined as an abnormal SE. The main outcomes measured were cardiac death and myocardial infarction (MI).

The investigators found an abnormal SE in 26 percent of patients (79), with 17 confirmed cases of MI and 14 cardiac deaths after an average follow-up of 2.9 years. Patients were divided into normal and abnormal groups based on SE risk (event rate, 0.6 versus 11.8 percent per year). Cardiac events were independently predicted by abnormal SE (hazard ratio [HR], 28.2), and the presence of any ischemia on SE (HR, 3.4). An incremental prognostic value was provided by SE over traditional clinical, stress electrocardiographic, and resting echocardiographic variables.

"In this cohort at increased risk for cardiovascular events, SE effectively risk-stratifies patients into normal SE (low risk) and abnormal SE (high risk) groups," the authors write.

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