Abstract 132: Cost-Effectiveness of Stress Echocardiography and Long-Term Outcomes in Framingham Risk Score Stratified Patients with Non-anginal Chest Pain, Normal ECG and Normal Cardiac Biomarkers

Background: We investigated cost-effectiveness of stress echocardiography (SE) and long-term outcomes in Framingham risk score (FRS) stratified patients referred for stress testing after having presented with non-anginal chest pain, normal ECG, normal cardiac biomarkers. Material and Methods: Of 619 consecutive patients, 238 patients with complete dataset were divided into groups based on the interquartile range of the FRS (Table). Cost per CAD diagnosis was inferred based on post-test likelihood of CAD assuming accepted clinical practice of cardiac catheterization in patients with a SE demonstrating inducible ischemia. Long-term outcomes were ascertained using the Social Security Death Index and hospital records. Cause of death was identified in all but 3 patients. Chi-square test and analysis of variance were used to analyse categorical and continuous variables. Results: Study population consisted of 48% females, 52+/- 12 years old, 23% diabetics, and 40% current smokers. Intermediate and high FRS patients were more likely to develop ischemia by SE (4% vs. 9% in higher FRS, p Conclusion: In patients presenting with non-anginal chest pain, normal EKG and normal biomarkers, long-term follow-up suggests very low cardiovascular mortality. In this patient population further stratification by stress testing does not aid in predicting cardiovascular outcomes nor is it cost-efficient. For differences vs. CAD patients: p