Echo Persantine International Coorporative (EPIC) Study Group, Echo Dobutamine Iternational Cooperative (EDIC) Study Group - Stress echo results predict mortality: a large-scale multicenter prospective international study

Objectives: The purpose of this study was to assess the long-term value of pharmacologic stress echocardiography with either dipyridamole or dobutamine for prediction of cardiac death in patients with proven or suspected coronary artery disease. Background: Stress echocardiography is an established cost-effective technique for the detection of coronary artery disease. Methods: From the EPIC - EDIC Data Bank 7333 patients (5452 males; 59±10 years) underwent pharmacologic stress echocardiography with either high dose dipyridamole (0.84 mg/Kg over 10’) (n= 4984) or high dose dobutamine (up to 40 mcg/Kg/3’) (n= 2349) (DET) for diagnostic purposes. Patients were followed-up for a mean of 2.6 years (range 1 to 206 months). Results: DET was positive for myocardial ischemia in 2854 (35%) and negative in 4479 (61%) patients. During the follow-up there were 161 cardiac deaths (sudden death and fatal myocardial infarction) (2.1% of the total population). Kaplan-Meier survival estimates showed a significant better outcome for those patients with negative pharmacological stress echocardiography test compared to those with a positive test (92 vs. 71.2%, p=0.0000). Conclusions: Pharmacologic stress echocardiography either with dipyridamole or dobutamine is effective in predicting cardiac death during a long-term follow-up. A negative stress echocardiography test result is related with a favorable outcome