Back to resultsA Study of Stress Echocardiography in Post-Menopausal Women at Risk for Coronary Disease
Primary Purpose
Coronary Artery Disease, Heart Disease
Status
Completed
Phase
Phase 4
Locations
United States
Study Type
Interventional
Intervention
Perflutren Lipid Microsphere Injectable Suspension
Sponsored by
About this trial
This is an interventional diagnostic trial for Coronary Artery Disease
Eligibility Criteria
Inclusion Criteria: Peri or Post menopausal women either: without symptoms but with risk factors for heart disease OR experiencing atypical chest pain, OR experiencing exertional dyspnea AND 2 or more risk factors for CAD Must be able to perform an exercise stress test Peri-or post-menopausal (including surgical menopause) based on history. Post-menopausal is defined as females age 40-65 who self-report the absence of menstrual periods for at least 12 months. Peri-menopausal is defined as females age 40-65 who self-report the absence or irregularity of menstrual periods for 6-12 months. Surgical menopause is defined as females who have had a bilateral salpingo-oophorectomy with or without hysterectomy. Exclusion Criteria: Previous confirmed heart disease
Sites / Locations
- Local Institution
- Local Institution
- Local Institution
Arms of the Study
Arm 1
Arm Type
Experimental
Arm Label
Definity
Arm Description
All patients will undergo a gray scale baseline unenhanced imaging session (apical 2- or 4 chamber view), as well as a DEFINITY (Perflutren Lipid Microsphere Injectable Suspension)-enhanced rest and a DEFINITY enhanced exercise or dobutamine stress echocardiography imaging session. The unenhanced and DEFINITY-enhanced rest and stress echocardiography imaging sessions will be performed on the same day. For the DEFINITY-enhanced imaging sessions all patients will receive diluted DEFINITY intravenously (IV). Diluted DEFINITY will be prepared by mixing 1 mL of activated DEFINITY® with 9 mL of normal saline in a 10 mL syringe.
Outcomes
Primary Outcome Measures
Number of Participants With Abnormal Contrast Stress Echocardiography and With Future Major Adverse Cardiac Events (MACE) at 2 and 5 Years Follow-Up
Peri- or post-menopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) received a Definity contrast-enhanced stress echocardiography study at baseline using either treadmill exercise or dobutamine stresss. Images were evaluated for wall motion abnormalities. The results were compared to patient history on 2-year and 5-year follow up to identify the potential of stress echocardiography for predicting those at higher risk of experiencing future cardiac events.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Secondary Outcome Measures
Number of Participants With Abnormal ECG and With Major Adverse Cardiac Events (MACE) at 2 Year Follow-Up
Prognostic value of stress ECG testing for identifying female patients at increased risk of major adverse cardiac events (MACE) at 2-year follow-up
Peri- or post-meopausal female subjects with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting ECG at baseline. ECG was evaluated as normal or abnormal. The results were compared to patient history on 2-year follow up to identify the potential for ECG to predict those at higher risk of experiencing future cardiac events.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Change in Brain Natriuretic Peptide (BNP) in Subjects With and Without Major Adverse Cardiac Events at 2-year Follow-up.
The value of exercise-induced changes in blood concentration of cardiac peptide, brain natriuretic peptide (BNP in pg/mL in blood), was assessed in identifying patients with cardiac events at 2-year follow-up. The change in mean BNP blood concentration from rest to stress at baseline is summarized using number of subjects with and without MACE at 2-year follow-up
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Change in Atrial Natriuretic Peptide (ANP) in Subjects With and Without Major Adverse Cardiac Events at 2-year Follow-up.
The value of exercise-induced changes in blood concentration of cardiac peptide, atrial natriuretic peptide (ANP in pg/mL in blood), was assessed in identifying patients with cardiac events at 2-year follow-up. The change in mean ANP blood concentration from rest to stress at baseline is summarized using number of subjects with and without major adverse cardiac events (MACE) at 2-year follow-up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Change in Brachial Artery Reactivity Was Assessed in in a Subset of Participants With and Without Major Adverse Cardiac Events at 2-year and 5-year Follow-up.
A subset of the study population of peri- or post-meopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) was assessed for brachial artery reactivity at baseline. Brachial diameter was assessed using ultrasound and a pressure cuff both before and after administration of sublingual nitroglycerin. The results were compared to patient history on 2-year and 5-year follow up to identify the potential for brachial artery reactivity to predict those at higher risk of experiencing future cardiac events.The brachial artery reactivity was summarized using number of subjects with and without MACE on follow-up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Mean Baseline Calcium Score of Participants With and Without Major Cardiac Events at 2-year Follow up.
Coronary artery calcium scoring assesses calcification of the coronary arteries using electron-beam computed tomography (EBCT). It is a sum of lesion scores of area and density above a threshold density. There is no intrinsic upper limit to the calcium score but values above 1000 may not be measurable.
A subset of peri- or post-meopausal females with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting EBCT at baseline. Images were evaluated for calcium score and results compared to patient history on 2-year follow up, Mean calcium score with confidence interval was summarized for subjects with and without major cardiac events (MACE) at 2-year follow up.
Calcium score for general population:
Score Description Relative Risk 0 No evidence of CAD 0 1-112 Average Risk of CAD 1.9 100-400 Moderate risk of CAD 4.3 400-999 High risk of CAD 7.2 1000 Very high risk of CAD 10.8
The Presence of Wall Motion Abnormalities on Definity Stress Echocardiography Assessed for Participants With Both Normal and Abnormal Angiography
In the sub-set of efficacy-evaluable participants who underwent clinically indicated coronary angiography, the accuracy of exercise echocardiography vs. angiography was determined for the detection of CAD. Positive angiography was defined as any stenosis greater than or equal to 50% in any vessel. Wall motion index change indicating abnormal motion was defined as greater than or equal to 13% in 2 or more segments. Angiography was required to have taken place within 60 days following stress echocardiography.
Participants With Positive and Negative Angiography Compared With Their ECG Results
In the sub-set of efficacy-evaluable participants who underwent clinically indicated coronary angiography, the accuracy of exercise ECG vs. angiography was determined for the detection of CAD. Positive angiography was defined as any stenosis greater than or equal to 50% in any vessel.
Number of Participants With Abnormal ECG and With Future Major Adverse Cardiac Events (MACE) at 5 Years Follow-Up
Prognostic value of stress ECG testing for identifying female patients at increased risk of major adverse cardiac events (MACE) at 5-year follow-up
Peri- or post-meopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting ECG at baseline. ECG was evaluated as normal or abnormal. The results were compared to patient history on 5-year follow up to identify the potential for ECG to predict those at higher risk of experiencing future major adverse cardiac events (MACE) at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Change in Brain Natriuretic Peptide (BNP) in Participants With and Without Major Adverse Cardiac Events at 5-year Follow-up.
The value of exercise-induced changes in blood concentration of the cardiac peptide, brain natriuretic peptide (BNP in pg/mL in blood), was assessed in identifying patients with cardiac events at 5-year follow-up. The change in mean BNP blood concentration at baseline from rest to stress is summarized using number of participants with and without MACE at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Change in Atrial Natriuretic Peptide (ANP) in Participants With and Without Major Adverse Cardiac Events at 5-year Follow-up.
The baseline value of exercise-induced changes in blood concentration of the cardiac peptide, atrial natriuretic peptide (ANP in pg/mL in blood), was assessed in identifying patients with cardiac events at 5-year follow-up. The change in mean ANP blood concentration from rest to stress at baseline was summarized using number of subjects with and without major adverse cardiac events (MACE) at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Mean Calcium Score of Participants With and Without Major Cardiac Events at 5-year Follow up.
Coronary artery calcium scoring assesses calcification of the coronary arteries using electron-beam computed tomography (EBCT). It is a sum of lesion scores of area and density above a threshold density. There is no intrinsic upper limit to the calcium score but values above 1000 may not be measurable.
A subset of peri- or post-meopausal females with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting EBCT at baseline. Images were evaluated for calcium score and results compared to patient history on 5-year follow up, Mean calcium score with confidence interval was summarized for subjects with and without major cardiac events (MACE) at 5-year follow up
Calcium score for general population:
Score Description Relative Risk 0 No evidence of CAD 0 1-112 Average Risk of CAD 1.9 100-400 Moderate risk of CAD 4.3 400-999 High risk of CAD 7.2 1000 Very high risk of CAD 10.8
Full Information
NCT ID
NCT00162370
First Posted
September 9, 2005
Last Updated
February 22, 2021
Sponsor
Lantheus Medical Imaging
1. Study Identification
Unique Protocol Identification Number
NCT00162370
Brief Title
A Study of Stress Echocardiography in Post-Menopausal Women at Risk for Coronary Disease
Official Title
SMART: Stress Echocardiography in Menopausal Women at Risk for Coronary Artery Disease Trial
Study Type
Interventional
2. Study Status
Record Verification Date
February 2021
Overall Recruitment Status
Completed
Study Start Date
April 2004 (undefined)
Primary Completion Date
September 2012 (Actual)
Study Completion Date
October 2012 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Lantheus Medical Imaging
4. Oversight
Data Monitoring Committee
No
5. Study Description
Brief Summary
The study is designed to see if stress echocardiography can be used as a screening exam in peri-, or post-menopausal women with a risk of developing of coronary artery disease and experiencing future cardiac events.
Detailed Description
The clinical trial is designed to determine the prognostic value of stress echocardiography as a screening examination in peri-, or post-menopausal female patients with an intermediate likelihood of coronary artery disease (CAD) based on risk factors to identify patients at higher risk of experiencing future cardiac events.Female patients who are able to adequately exercise will undergo a symptom-limited exercise echocardiogram. Patients who are unable to adequately exercise or are predicted to be unable to exercise adequately (because of orthopedic/neurologic limitations, lung disease or debility), will perform dobutamine stress echocardiography. All patients will receive DEFINITY at rest and stress to enhance wall motion assessment.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Coronary Artery Disease, Heart Disease
7. Study Design
Primary Purpose
Diagnostic
Study Phase
Phase 4
Interventional Study Model
Single Group Assignment
Masking
None (Open Label)
Allocation
N/A
Enrollment
400 (Actual)
8. Arms, Groups, and Interventions
Arm Title
Definity
Arm Type
Experimental
Arm Description
All patients will undergo a gray scale baseline unenhanced imaging session (apical 2- or 4 chamber view), as well as a DEFINITY (Perflutren Lipid Microsphere Injectable Suspension)-enhanced rest and a DEFINITY enhanced exercise or dobutamine stress echocardiography imaging session. The unenhanced and DEFINITY-enhanced rest and stress echocardiography imaging sessions will be performed on the same day. For the DEFINITY-enhanced imaging sessions all patients will receive diluted DEFINITY intravenously (IV). Diluted DEFINITY will be prepared by mixing 1 mL of activated DEFINITY® with 9 mL of normal saline in a 10 mL syringe.
Intervention Type
Drug
Intervention Name(s)
Perflutren Lipid Microsphere Injectable Suspension
Other Intervention Name(s)
DEFINITY
Intervention Description
Activated DEFINITY 10ug/kg by bolus injection
Primary Outcome Measure Information:
Title
Number of Participants With Abnormal Contrast Stress Echocardiography and With Future Major Adverse Cardiac Events (MACE) at 2 and 5 Years Follow-Up
Description
Peri- or post-menopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) received a Definity contrast-enhanced stress echocardiography study at baseline using either treadmill exercise or dobutamine stresss. Images were evaluated for wall motion abnormalities. The results were compared to patient history on 2-year and 5-year follow up to identify the potential of stress echocardiography for predicting those at higher risk of experiencing future cardiac events.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
2 year and 5 year follow up
Secondary Outcome Measure Information:
Title
Number of Participants With Abnormal ECG and With Major Adverse Cardiac Events (MACE) at 2 Year Follow-Up
Description
Prognostic value of stress ECG testing for identifying female patients at increased risk of major adverse cardiac events (MACE) at 2-year follow-up
Peri- or post-meopausal female subjects with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting ECG at baseline. ECG was evaluated as normal or abnormal. The results were compared to patient history on 2-year follow up to identify the potential for ECG to predict those at higher risk of experiencing future cardiac events.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
2-year follow-up
Title
Change in Brain Natriuretic Peptide (BNP) in Subjects With and Without Major Adverse Cardiac Events at 2-year Follow-up.
Description
The value of exercise-induced changes in blood concentration of cardiac peptide, brain natriuretic peptide (BNP in pg/mL in blood), was assessed in identifying patients with cardiac events at 2-year follow-up. The change in mean BNP blood concentration from rest to stress at baseline is summarized using number of subjects with and without MACE at 2-year follow-up
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
2 year follow up
Title
Change in Atrial Natriuretic Peptide (ANP) in Subjects With and Without Major Adverse Cardiac Events at 2-year Follow-up.
Description
The value of exercise-induced changes in blood concentration of cardiac peptide, atrial natriuretic peptide (ANP in pg/mL in blood), was assessed in identifying patients with cardiac events at 2-year follow-up. The change in mean ANP blood concentration from rest to stress at baseline is summarized using number of subjects with and without major adverse cardiac events (MACE) at 2-year follow-up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
2 year follow up
Title
Change in Brachial Artery Reactivity Was Assessed in in a Subset of Participants With and Without Major Adverse Cardiac Events at 2-year and 5-year Follow-up.
Description
A subset of the study population of peri- or post-meopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) was assessed for brachial artery reactivity at baseline. Brachial diameter was assessed using ultrasound and a pressure cuff both before and after administration of sublingual nitroglycerin. The results were compared to patient history on 2-year and 5-year follow up to identify the potential for brachial artery reactivity to predict those at higher risk of experiencing future cardiac events.The brachial artery reactivity was summarized using number of subjects with and without MACE on follow-up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
2 year and 5 year follow up
Title
Mean Baseline Calcium Score of Participants With and Without Major Cardiac Events at 2-year Follow up.
Description
Coronary artery calcium scoring assesses calcification of the coronary arteries using electron-beam computed tomography (EBCT). It is a sum of lesion scores of area and density above a threshold density. There is no intrinsic upper limit to the calcium score but values above 1000 may not be measurable.
A subset of peri- or post-meopausal females with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting EBCT at baseline. Images were evaluated for calcium score and results compared to patient history on 2-year follow up, Mean calcium score with confidence interval was summarized for subjects with and without major cardiac events (MACE) at 2-year follow up.
Calcium score for general population:
Score Description Relative Risk 0 No evidence of CAD 0 1-112 Average Risk of CAD 1.9 100-400 Moderate risk of CAD 4.3 400-999 High risk of CAD 7.2 1000 Very high risk of CAD 10.8
Time Frame
2 year follow up
Title
The Presence of Wall Motion Abnormalities on Definity Stress Echocardiography Assessed for Participants With Both Normal and Abnormal Angiography
Description
In the sub-set of efficacy-evaluable participants who underwent clinically indicated coronary angiography, the accuracy of exercise echocardiography vs. angiography was determined for the detection of CAD. Positive angiography was defined as any stenosis greater than or equal to 50% in any vessel. Wall motion index change indicating abnormal motion was defined as greater than or equal to 13% in 2 or more segments. Angiography was required to have taken place within 60 days following stress echocardiography.
Time Frame
60 days
Title
Participants With Positive and Negative Angiography Compared With Their ECG Results
Description
In the sub-set of efficacy-evaluable participants who underwent clinically indicated coronary angiography, the accuracy of exercise ECG vs. angiography was determined for the detection of CAD. Positive angiography was defined as any stenosis greater than or equal to 50% in any vessel.
Time Frame
60 days
Title
Number of Participants With Abnormal ECG and With Future Major Adverse Cardiac Events (MACE) at 5 Years Follow-Up
Description
Prognostic value of stress ECG testing for identifying female patients at increased risk of major adverse cardiac events (MACE) at 5-year follow-up
Peri- or post-meopausal female participants with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting ECG at baseline. ECG was evaluated as normal or abnormal. The results were compared to patient history on 5-year follow up to identify the potential for ECG to predict those at higher risk of experiencing future major adverse cardiac events (MACE) at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
5 year follow up
Title
Change in Brain Natriuretic Peptide (BNP) in Participants With and Without Major Adverse Cardiac Events at 5-year Follow-up.
Description
The value of exercise-induced changes in blood concentration of the cardiac peptide, brain natriuretic peptide (BNP in pg/mL in blood), was assessed in identifying patients with cardiac events at 5-year follow-up. The change in mean BNP blood concentration at baseline from rest to stress is summarized using number of participants with and without MACE at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
5 year follow up
Title
Change in Atrial Natriuretic Peptide (ANP) in Participants With and Without Major Adverse Cardiac Events at 5-year Follow-up.
Description
The baseline value of exercise-induced changes in blood concentration of the cardiac peptide, atrial natriuretic peptide (ANP in pg/mL in blood), was assessed in identifying patients with cardiac events at 5-year follow-up. The change in mean ANP blood concentration from rest to stress at baseline was summarized using number of subjects with and without major adverse cardiac events (MACE) at 5-year follow up.
Major adverse cardiac events (MACE) are defined as
Cardiac death
Myocardial infarction
Cardiac revascularization (PCI or CABG)
Hospitalization for chest pain or to rule out myocardial infarction
Development of typical angina
Development of heart failure
Time Frame
5 year follow up
Title
Mean Calcium Score of Participants With and Without Major Cardiac Events at 5-year Follow up.
Description
Coronary artery calcium scoring assesses calcification of the coronary arteries using electron-beam computed tomography (EBCT). It is a sum of lesion scores of area and density above a threshold density. There is no intrinsic upper limit to the calcium score but values above 1000 may not be measurable.
A subset of peri- or post-meopausal females with an intermediate pre-test likelihood of coronary artery disease (CAD) received resting EBCT at baseline. Images were evaluated for calcium score and results compared to patient history on 5-year follow up, Mean calcium score with confidence interval was summarized for subjects with and without major cardiac events (MACE) at 5-year follow up
Calcium score for general population:
Score Description Relative Risk 0 No evidence of CAD 0 1-112 Average Risk of CAD 1.9 100-400 Moderate risk of CAD 4.3 400-999 High risk of CAD 7.2 1000 Very high risk of CAD 10.8
Time Frame
5 year follow up
10. Eligibility
Sex
Female
Minimum Age & Unit of Time
40 Years
Maximum Age & Unit of Time
65 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Peri or Post menopausal women either:
without symptoms but with risk factors for heart disease OR
experiencing atypical chest pain, OR
experiencing exertional dyspnea AND 2 or more risk factors for CAD
Must be able to perform an exercise stress test
Peri-or post-menopausal (including surgical menopause) based on history.
Post-menopausal is defined as females age 40-65 who self-report the absence of menstrual periods for at least 12 months.
Peri-menopausal is defined as females age 40-65 who self-report the absence or irregularity of menstrual periods for 6-12 months.
Surgical menopause is defined as females who have had a bilateral salpingo-oophorectomy with or without hysterectomy.
Exclusion Criteria:
Previous confirmed heart disease
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Sharon Mulvagh, MD
Organizational Affiliation
Mayo Clinic
Official's Role
Principal Investigator
Facility Information:
Facility Name
Local Institution
City
Scottsdale
State/Province
Arizona
ZIP/Postal Code
85259
Country
United States
Facility Name
Local Institution
City
Jacksonville
State/Province
Florida
ZIP/Postal Code
32224
Country
United States
Facility Name
Local Institution
City
Rochester
State/Province
Minnesota
ZIP/Postal Code
55905
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Citations:
PubMed Identifier
29672210
Citation
Abdelmoneim SS, Ball CA, Mantovani F, Hagen ME, Eifert-Rain S, Wilansky S, Castello R, Pellikka PA, Best PJM, Mulvagh SL. Prognostic Utility of Stress Testing and Cardiac Biomarkers in Menopausal Women at Low to Intermediate Risk for Coronary ARTery Disease (SMART Study): 5-Year Outcome. J Womens Health (Larchmt). 2018 May;27(5):542-551. doi: 10.1089/jwh.2017.6506. Epub 2018 Apr 19.
Results Reference
derived
PubMed Identifier
24932797
Citation
Mantovani F, Abdelmoneim SS, Zysek V, Eifert-Rain S, Mulvagh SL. Effect of stress echocardiography testing on changes in cardiovascular risk behaviors in postmenopausal women: a prospective survey study. J Womens Health (Larchmt). 2014 Jul;23(7):581-7. doi: 10.1089/jwh.2013.4604. Epub 2014 Jun 16.
Results Reference
derived
Learn more about this trial
A Study of Stress Echocardiography in Post-Menopausal Women at Risk for Coronary Disease
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