Table A2

Noninvasive Risk Stratification

High-risk (>3% annual mortality rate)
 1. Severe resting left ventricular dysfunction (LVEF <35%)
 2. High-risk treadmill score (score ≤−11)
 3. Severe exercise left ventricular dysfunction (exercise LVEF <35%)
 4. Stress-induced large perfusion defect (particularly if anterior)
 5. Stress-induced multiple perfusion defects of moderate size
 6. Large, fixed perfusion defect with LV dilation or increased lung uptake (thallium-201)
 7. Stress-induced moderate perfusion defect with LV dilation or increased lung uptake (thallium-201)
 8. Echocardiographic wall motion abnormality (involving >2 segments) developing at low dose of dobutamine (≤10 mg/kg/min) or at a low heart rate (<120 beats/min)
 9. Stress echocardiographic evidence of extensive ischemia
Intermediate-risk (1% to 3% annual mortality rate)
 1. Mild/moderate resting left ventricular dysfunction (LVEF 35% to 49%)
 2. Intermediate-risk treadmill score (score between −11 and <5)
 3. Stress-induced moderate perfusion defect without LV dilation or increased lung intake (thallium-201)
 4. Limited stress echocardiographic ischemia with a wall motion abnormality only at higher doses of dobutamine involving less than or equal to 2 segments
Low-risk (<1% annual mortality rate)
 1. Low-risk treadmill score (score ≥5)
 2. Normal or small myocardial perfusion defect at rest or with stress
 3. Normal stress echocardiographic wall motion or no change of limited resting wall motion abnormalities during stress

LV = left ventricular; LVEF = left ventricular ejection fraction.

  • Although the published data are limited, patients with these findings will probably not be at low risk in the presence of either a high-risk treadmill score or severe resting left ventricular dysfunction (LVEF <35%). Reprinted with permission from Patel et al. (1).