PMID: 11345364May 10, 2001Paper

Prognostic stratification of diabetic patients by exercise echocardiography

Journal of the American College of Cardiology
Abdou ElhendyPatricia A Pellikka

Abstract

The aim of this study was to assess the incremental value of exercise echocardiography for the risk stratification of diabetic patients. There are currently insufficient outcome data in diabetic patients to define the role of stress echocardiography as a prognostic tool. 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). 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). Exercise echocardiography provides incremental data for risk stratificat...Continue Reading

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