Abstract 605: Characteristics and Outcomes of Patients With Abnormal Stress Echocardiograms and Angiographically Mild Coronary Artery Disease (<50% Stenoses) or Normal Coronary Arteries
Background: Abnormal cardiac stress imaging findings are not always associated with angiographically significant CAD. The outcomes of patients with ‘false positive’ and ‘true positive’ findings have not been extensively examined. In this study, we sought to describe the characteristics and outcomes of patients with abnormal stress echocardiography who have ‘false positive’ results compared to patients who have ‘true positive’ results.
Methods and Results: We identified 1,477 consecutive patients (61 % male) with abnormal stress echocardiography who underwent coronary arteriography within 30 days. At coronary arteriography 997 patients (67.5%) had “true positive” studies defined as angiographically significant (≥50%) stenoses, 480 (32.5%) had “false positive” studies defined as <50% stenoses. Of a subgroup of 605 patients with markedly abnormal stress echocardiographic findings, 28% had <50% stenoses. Death from any cause was ascertained with use of the Social Security death index. During an average follow-up period of 2.4±1.0 years, there were140 deaths. There was no difference in the adjusted likelihood of subsequent death for patients with <50% stenoses compared to patients with ≥50% stenoses after abnormal stress echocardiography (RR=1.02, 95% CI=0.64 –1.58; p=0.93).
Conclusions: A sizable proportion of patients who have abnormal stress echocardiograms and who are referred for coronary angiography, have “false positive” studies. The outcome of patients with “false-positive” results was similar to that of patients with “true positive” results. This finding suggests that patients with “false positive” studies require intensive risk factor management and careful followup.