Cortigiani et al reported a simple score for evaluating a patient undergoing stress echocardiography (SE). This can help to identify a patient who may benefit from more aggressive management. The authors are from the Institute of Clinical Physiology in Pisa, Italy.
Patient selection: stress echocardiography
Parameters:
(1) age in years
(2) sex
(3) diabetes mellitus
(4) left bundle branch block (LBBB)
(5) ongoing anti-ischemic therapy
(6) wall movement abnormality (WMA) at rest
Parameter
Finding
Points
age in years
<= 65 years
0
> 65 years
1 (odds ratio 3.0)
sex
female
0
male
1 (odds ratio 1.3)
diabetes mellitus
absent
0
present
1 (odds ratio 1.7)
left bundle branch block
absent
0
present
1 (odds ratio 1.5)
ongoing anti-ischemic therapy
absent
0
present
1 (odds ratio 1.3)
wall movement abnormality at rest
absent
0
present
1 (odds ratio 2.0)
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
An additional risk factor is the presence of ischemia at stress echo (SE).
Score
Survival at 6 Years with No Ischemia at SE
Survival at 6 Years with Ischemia at SE
0
98%
100%
1
96%
90%
2
90%
83%
3
83%
75%
4
72%
66%
5 or 6
66%
45%
from Figure 3
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