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European Journal of Echocardiography 2003 4(3):202-208; doi:10.1016/S1525-2167(02)00165-8
© 2003 by European Society of Cardiology
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Copyright © 2003, The European Society of Cardiology

Prognostic value of pharmacological stress echocardiography in diabetic patients

A D'Andrea1,*, S Severino2, P Caso2, L De Simone2, B Liccardo1, A Forni3, M Pascotto3, G Di Salvo1, M Scherillo2, N Mininni2 and R Calabrò3

1Medical–Surgical Physiopathology of Cardiopulmunar and Respiratory System and Associated Biotechnologies, Second University of Naples, Naples, Italy
2Department of Cardiology, Monaldi Hospital, Naples, Italy
3Department of Cardiology, Second University of Naples, Naples, Italy

* Address correspondence to: Antonello D'Andrea, Department of Cardiology, Second University of Naples, Corsa Europa 72, 80127 Naples, Italy. Tel: +81/643055; Fax: +81/7145205. adandrea{at}synapsis.it


  Abstract

Our study was undertaken to assess the prognostic significance of pharmacological stress echocardiography in 325 diabetic patients. Pharmacological stress echocardiography was performed for diagnosis of coronary artery disease in 128 patients, and for risk stratification in 197 patients. Follow-up was 34 months. Cardiac-related death and non-fatal myocardial infarction were considered hard events. During the follow-up period, there were 38 deaths and 23 acute non-fatal myocardial infarctions. By univariate analysis, a pharmacological stress echocardiography positive response for ischaemia indicated an increased risk of cardiovascular death. However, by multivariate analysis, advanced age and peak ejection fraction <40% were the only independent predictors of cardiac death. The same peak ejection fraction (EF) <40%, rest wall motion score index and previous myocardial infarction were independent predictors of hard events. After dividing the population into two subgroups on the basis of EF at rest, only a peak EF <40% and a pharmacological stress echocardiography positive test were powerful independent predictors of cardiovascular mortality.

Keywords: stress echocardiography; prognosis; coronary artery disease; diabetes mellitus; ejection fraction


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