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Vol 4, No 3 (2003): Practical Diabetology
Original articles (translated)
Published online: 2003-05-22
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Prognostic value of dobutamine stress echocardiography in patients with diabetes

Fabiola B. Sozzi, Abdou Elhendy, Jos R.T.C. Roelandt, Ron T. van Domburg, Arend F.L. Schinkel, Eleni C. Vourvouri, Jeroen J. Bax, Johan De Sutter, Alberico Borghetti, Don Poldermans
Diabetologia Praktyczna 2003;4(3):237-244.

open access

Vol 4, No 3 (2003): Practical Diabetology
Original articles (translated)
Published online: 2003-05-22

Abstract

INTRODUCTION. The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in patients with diabetes. The role of pharmacologic stress echocardiography in the risk stratification of diabetic patients has not been well defined.
MATERIAL AND METHODS. We studied 396 diabetic patients (mean age 61 ± 11 years, 252 men [64%]) with limited exercise capacity who underwent DSE for evaluation of known or suspected coronary artery disease (CAD). End points were hard cardiac events (cardiac death and nonfatal myocardial infarction) and all causes of mortality.
RESULTS. During a median follow-up of 3 years, 97 patients (24%) died (55 cardiac deaths), and 27 patients had nonfatal myocardial infarction. In an incremental multivariate analysis model, clinical predictors of hard cardiac events were history of congestive heart failure, previous myocardial infarction, hypercholesterolemia, and ejection fraction at rest. The percentage of ischemic segments was incremental to the clinical model in the prediction of hard cardiac events (c2 = 37 vs. 18, P < 0.05). Clinical predictors of all causes of mortality were history of congestive heart failure, age, hypercholesterolemia, and ejection fraction at rest. Wall motion score index at peak stress was incremental to the clinical model in the prediction of mortality (c2 = 52 vs. 43, P < 0.05).
CONCLUSIONS. DSE provides incremental data for the prediction of mortality and hard cardiac events in patients with diabetes who are unable to perform an adequate exercise stress test.

Abstract

INTRODUCTION. The aim of this study was to assess the incremental value of dobutamine stress echocardiography (DSE) for the risk stratification of diabetic patients who are unable to perform an adequate exercise stress test. Exercise capacity is frequently impaired in patients with diabetes. The role of pharmacologic stress echocardiography in the risk stratification of diabetic patients has not been well defined.
MATERIAL AND METHODS. We studied 396 diabetic patients (mean age 61 ± 11 years, 252 men [64%]) with limited exercise capacity who underwent DSE for evaluation of known or suspected coronary artery disease (CAD). End points were hard cardiac events (cardiac death and nonfatal myocardial infarction) and all causes of mortality.
RESULTS. During a median follow-up of 3 years, 97 patients (24%) died (55 cardiac deaths), and 27 patients had nonfatal myocardial infarction. In an incremental multivariate analysis model, clinical predictors of hard cardiac events were history of congestive heart failure, previous myocardial infarction, hypercholesterolemia, and ejection fraction at rest. The percentage of ischemic segments was incremental to the clinical model in the prediction of hard cardiac events (c2 = 37 vs. 18, P < 0.05). Clinical predictors of all causes of mortality were history of congestive heart failure, age, hypercholesterolemia, and ejection fraction at rest. Wall motion score index at peak stress was incremental to the clinical model in the prediction of mortality (c2 = 52 vs. 43, P < 0.05).
CONCLUSIONS. DSE provides incremental data for the prediction of mortality and hard cardiac events in patients with diabetes who are unable to perform an adequate exercise stress test.
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Keywords

dobutamine stress echocardiography; coronary artery disease; diabetes mellitus

About this article
Title

Prognostic value of dobutamine stress echocardiography in patients with diabetes

Journal

Clinical Diabetology

Issue

Vol 4, No 3 (2003): Practical Diabetology

Pages

237-244

Published online

2003-05-22

Bibliographic record

Diabetologia Praktyczna 2003;4(3):237-244.

Keywords

dobutamine stress echocardiography
coronary artery disease
diabetes mellitus

Authors

Fabiola B. Sozzi
Abdou Elhendy
Jos R.T.C. Roelandt
Ron T. van Domburg
Arend F.L. Schinkel
Eleni C. Vourvouri
Jeroen J. Bax
Johan De Sutter
Alberico Borghetti
Don Poldermans

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