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J Am Coll Cardiol. 2001 May;37(6):1551-7.

Prognostic stratification of diabetic patients by exercise echocardiography.

Author information

1
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.

Abstract

OBJECTIVES:

The aim of this study was to assess the incremental value of exercise echocardiography for the risk stratification of diabetic patients.

BACKGROUND:

There are currently insufficient outcome data in diabetic patients to define the role of stress echocardiography as a prognostic tool.

METHODS:

We studied the prognostic value of exercise echocardiography in 563 patients with diabetes mellitus (mean age 64 +/- 11 years, 336 men) and known or suspected ischemic heart disease (IHD).

RESULTS:

Cardiac events occurred in 50 patients (cardiac death in 23 and nonfatal myocardial infarction [MI] in 27) during a median follow-up period of three years. Event rate was lower in patients with normal as compared to those with abnormal exercise echocardiography at one year (0% vs. 1.9%), three years (1.8% vs. 11.9%), and five years (7.6% vs. 23.3%), respectively (p = 0.0001). Patients with multivessel distribution of echocardiographic abnormalities had the highest event rate (2.9% at one year, 15.2% at three years, and 32.8% at five years). In an incremental multivariate analysis model, exercise echocardiography increased the chi-square of the clinical and exercise ECG model from 29 to 44.8 (p = 0.0001).

CONCLUSIONS:

Exercise echocardiography provides incremental data for risk stratification of diabetic patients with known or suspected IHD. Patients with a normal exercise echocardiogram have a low event rate. Patients with multivessel distribution of exercise echocardiographic abnormalities are at the highest risk of cardiac events, as one-third of these patients experience cardiac death or nonfatal MI during the five years following exercise echocardiography.

PMID:
11345364
DOI:
10.1016/s0735-1097(01)01199-8
[Indexed for MEDLINE]
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