Article

Stress Echocardiography in a Caribbean Population: Predictors and Performance

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Abstract

Background: Stress echocardiography is a well-established procedure for diagnosis of coronary artery disease. It's utility in the Caribbean population is still being explored. The aim of our study was to explore incidence of abnormal stress echocardiography and ascertain ischemia predictors in consecutive patient’s cohort referred to cardiology clinic in Jamaica. Methods: Retrospective analysis of the data of 481 patients referred to Heart Institute of the Caribbean, Kingston, Jamaica for stress echocardiography from 2012 to 2016. Independent predictors of ischemia on stress echocardiography was identified by using multivariate logistic regression analysis. Results: The cohort average age was 61 years, 58.4% were females. 32.6% of patients underwent exercise Stress echocardiography, 67.4% of patients underwent dobutamine Stress echocardiography. 18.4% of subjects had new wall motion abnormalities suggestive of ischemia. In multivariate logistic regression model, age (OR 1.028; p=0.012) and male gender (OR, 2.35; P = 0.005) were shown to be significant independent predictors of a positive stress echo result in this population. Conclusions: Stress echocardiography is outstanding noninvasive safe tool for detection of ischemia. Incidence of ischemia among unselected Jamaican patient population referred for stress echocardiography at Heart Institute of the Caribbean was about 18.4% and coronary artery disease is more likely to be present in men and the elderly.

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