Perfusão pra quê?

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Methods and Results—We randomized symptomatic women with suspected CAD, an interpretable ECG, and ≥5 metabolic equivalents on the Duke Activity Status Index to 1 of 2 diagnostic strategies: ETT or exercise MPI. The primary end point was 2-year incidence of major adverse cardiac events, defined as CAD death or hospitalization for an acute coronary syndrome or heart failure. A total of 824 women were randomized to ETT or exercise MPI. For women randomized to ETT, ECG results were normal in 64%, indeterminate in 16%, and abnormal in 20%. By comparison, the exercise MPI results were normal in 91%, mildly abnormal in 3%, and moderate to severely abnormal in 6%. At 2 years, there was no difference in major adverse cardiac events (98.0% for ETT and 97.7% for MPI; P=0.59). Compared with ETT, index testing costs were higher for exercise MPI (P<0.001), whereas downstream procedural costs were slightly lower (P=0.0008). Overall, the cumulative diagnostic cost savings was 48% for ETT compared with exercise MPI (P<0.001). Conclusions—In low-risk, exercising women, a diagnostic strategy that uses ETT versus exercise MPI yields similar 2-year posttest outcomes while providing significant diagnostic cost savings. The ETT with selective follow-up testing should be considered as the initial diagnostic strategy in symptomatic women with suspected CAD.
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É incrível como estudos clínicos grandes acabam com nossas (deles) expectativas de usar exames caros em todos.
Mais um mostra que é melhor fazer ergométrico do que cintilo até mesmo em mulheres.
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Essa semana tive meu primeiro caso de infarto 15 dias após uma tomo de coronária normal.
A família do paciente ficou indignada.
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Bem vinda, TOMO, ao mundo do ECG, ERGO,ECO, ECOSTRESS, CINTILO e outros falíveis métodos de prever o futuro!
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