{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T22:51:36Z","timestamp":1794005496354,"version":"4.8.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,11,12]],"date-time":"2024-11-12T00:00:00Z","timestamp":1731369600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100018835","name":"Cardiovascular Clinical Research Facility, University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100018835","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Ultromics Ltd"},{"DOI":"10.13039\/100008270","name":"Lantheus Medical Imaging Inc.","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008270","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013373","name":"NIHR Oxford Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013373","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000769","name":"University of Oxford","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000769","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,1,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Stress echocardiography is widely used to assess patients with chest pain. The clinical value of a positive or negative test result to inform on likely longer-term outcomes when applied in real-world practice across a healthcare system has not been previously reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Five thousand five hundred and three patients recruited across 32 UK NHS hospitals between 2018 and 2022, participating in the EVAREST\/BSE-NSTEP prospective cohort study, with data on medical outcomes up to 2023 available from NHS England were included in the analysis. Stress echocardiography results were related to outcomes, including death, procedures, hospital admissions, and relevant cardiovascular diagnoses, based on Kaplan\u2013Meier analysis and Cox proportional hazard ratios (HRs). Median follow-up was 829 days (interquartile range 224\u20131434). A positive stress echocardiogram was associated with a greater risk of myocardial infarction [HR 2.71, 95% confidence interval (CI) 1.73\u20134.24, P &amp;lt; 0.001] and a composite endpoint of cardiac-related mortality and myocardial infarction (HR 2.03, 95% CI 1.41\u20132.93, P &amp;lt; 0.001). Hazard ratios increased with ischaemic burden. A negative stress echocardiogram identified an event-free \u2018warranty period\u2019 of at least 5 years in patients with no prior history of coronary artery disease and 4 years for those with disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In real-world practice, the degree of myocardial ischaemia recorded by clinicians at stress echocardiography correctly categorizes risk of future events over the next 5 years. Reporting a stress echocardiogram as negative correctly identifies patients with no greater than a background risk of cardiovascular events over a similar time period.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjci\/jeae291","type":"journal-article","created":{"date-parts":[[2024,11,9]],"date-time":"2024-11-09T23:19:09Z","timestamp":1731194349000},"page":"187-196","source":"Crossref","is-referenced-by-count":19,"title":["Long-term outcomes after stress echocardiography in real-world practice: a 5-year follow-up of the UK EVAREST study"],"prefix":"10.1093","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9875-4983","authenticated-orcid":false,"given":"William","family":"Woodward","sequence":"first","affiliation":[{"name":"Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford , John Radcliffe Hospital, Headley Way, Oxford OX3 9DU ,","place":["UK"]},{"name":"Barts and the London School of Medicine and 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of Life Sciences, University of Leicester , Leicester ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annabelle","family":"McCourt","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford , John Radcliffe Hospital, Headley Way, Oxford OX3 9DU ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Dockerill","sequence":"additional","affiliation":[{"name":"Cardiovascular Clinical Research Facility, Division of Cardiovascular Medicine, University of Oxford , John Radcliffe Hospital, Headley Way, Oxford OX3 9DU ,","place":["UK"]},{"name":"Division of Imaging Sciences and Biomedical Engineering, Kings College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Balkhausen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Royal Berkshire Hospital NHS Foundation Trust , Reading ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2265-0501","authenticated-orcid":false,"given":"Badrinathan","family":"Chandrasekaran","sequence":"additional","affiliation":[{"name":"Wiltshire Cardiac Centre, Great Western Hospitals NHS Foundation Trust , Swindon ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soroosh","family":"Firoozan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Wycombe Hospital, Buckingham Healthcare NHS Trust , Wycombe ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0231-7605","authenticated-orcid":false,"given":"Attila","family":"Kardos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Milton Keynes University Hospital NHS Foundation Trust , Milton Keynes ,","place":["UK"]},{"name":"Faculty of 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