Inducible Ischemia, Most Often Without Angina, Portends CHD Recurrence

21 july 2008--Nearly a quarter of patients with stable coronary disease have inducible ischemia — yet more than three-quarters of that group do not report having angina, according to an Archives of Internal Medicine study.
Researchers tested nearly 950 patients with stable coronary heart disease for ischemia (with treadmill echocardiography testing) and surveyed them for angina (via questionnaire). During a mean follow-up of nearly 4 years, CHD death or nonfatal MI occurred in:
7% of those without inducible ischemia or angina;
10% of those with angina alone;
21% with ischemia alone;
23% with both ischemia and angina.
Inducible ischemia alone carried an adjusted hazard ratio for CHD events of 2.2, while ischemia plus angina carried a ratio of 3.2.
The authors comment that their findings suggest a "potential benefit of routine stress testing in outpatients with stable CHD, regardless of symptoms."