Prognostic methods in acute coronary artery disease

Assessment Objective

This report evaluates the scientific evidence on noninvasive methods of risk assessment during the course following acute coronary artery disease. The noninvasive methods covered by the report include cardiac stress testing, echocardiography during activity and at rest, isotopic methods, special EKG methods, and biochemical markers. Assessment was designed as a structured literature review and was conducted for the period when clot-dissolving treatment was used in practice, 1990 through 1998. Only studies with prognostic events in terms of death, re-infarction, or angina were included. The health economic aspects addressed in published articles were considered and enhanced through an analysis by the project group.

Assessment Strategy

Structured literature review.

Primary Data Collection

Systematic review of the literature, including databases, review of reference lists. Sample based on criteria defined in protocols. Literature search limited to 1990 through 1998.

Data Criteria; Types of Studies Included

All original studies of the prognostic value of the above mentioned methods. A methods prognostic impact on mortality for at least 6 months is the most important prognostic variable. The secondary prognostic variables are non-fatal cardiovascular events.

Review of Publications

Review involved the project group, the SBU Board of Directors, the SBU Scientific Advisory Committee, and an external review group. The literature available on each method was first reviewed by two referees and then critically reviewed by the entire project group.