Negative exercise stress echocardiography and long-term outcomes: insights from a retrospective cohort study
Authors' conclusion
Negative ESE generally predicts low risk; however, non-diagnostic or abnormal non-ischaemic GPC findings show subtle prognostic differences undetected by conventional analysis.
Study context
- Population
- Patients with negative treadmill exercise stress echocardiography at a tertiary hospital in Santander, Spain, 2017–2023
- Participants
- 788 patients
- Exposure
- Non-diagnostic negative or abnormal non-ischaemic exercise stress echocardiography (ESE) vs diagnostic negative ESE
- Outcome
- Composite of:
- All-cause mortality
- CV death
- Ischaemic hospitalisation
- Coronary angiography
- Follow-up
- Mean 71 months
Methodological detailssingle-centre, inverse probability of treatment weighting (IPTW), generalised pairwise comparisons
- Single-centre
- IPTW
- Generalised pairwise comparisons
Main finding
As reported in the abstract
Each group vs diagnostic negativeHazard ratio (95% CI)
Non-diagnostic negative
0.92(0.49–1.72)
Abnormal non-ischaemic
0.80(0.24–2.61)
- Overall event rate
- 3.2 per 100 patient-years
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| GPC: angiography and mortalityNon-diagnostic negative vs Diagnostic negative · more angiographies | P = 0.04 |
| GPC: angiography and mortalityAbnormal non-ischaemic vs Diagnostic negative · greater mortality | P = 0.02 |
Independent risk predictors
- T2DM, HR
- 2.13 (95% CI 1.13 to 4.03)
- LVEF, HR per 1% increase
- 0.97 (95% CI 0.94 to 0.99)
Generalised pairwise comparisons (GPC): angiography and mortality
- Similar composite outcomes
Original publication
Negative exercise stress echocardiography and long-term outcomes: insights from a retrospective cohort study. Heart. Published 31 December 2025. doi:10.
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