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Cardiology Dobutamine/echo predicts cardiac events in diabetics without heart disease
Cardiology Dobutamine/echo predicts cardiac events in diabetics without heart disease
Dobutamine/echo predicts cardiac events in diabetics without heart disease
Monday, 29 November 1999 19:00 | 
| Specialties - Cardiology |
Identifying myocardial ischemia with dobutamine stress echocardiography is useful in predicting cardiac events in asymptomatic diabetic patients with no history of coronary artery disease, new research indicates.
Identifying myocardial ischemia with dobutamine stress echocardiography is useful in predicting cardiac events in asymptomatic diabetic patients with no history of coronary artery disease, new research indicates.
Previous reports have shown that dobutamine stress echocardiography is of prognostic value in diabetic patients, but most of the studies have focused on individuals with cardiac symptoms or a history of heart disease. Whether echocardiography-detected ischemia can predict cardiac events in diabetics with neither of these factors has not been studied.
As reported in the American Journal of Cardiology for May 1, Dr. Fabiola B. Sozzi, from Fondazione Ospedale Maggiore in Milan, Italy, and colleagues addressed this question in a study of 161 asymptomatic patients with type 2 diabetes who were followed for a median of five years.
Forty-five patients (28 per cent) had myocardial ischemia on dobutamine stress testing, the researchers report. During follow-up, 40 patients died (25 per cent), including 18 from cardiac causes, and seven patients had a nonfatal myocardial infarction.
Patients with myocardial ischemia on echocardiography were at increased risk for cardiac death and nonfatal myocardial infarction (p = 0.03). At five years, the rate of this composite outcome was 24 per cent with an abnormal exam result and 11 per cent with a normal result.
Coupled with prior results, the new findings suggest that dobutamine stress echocardiography is useful in predicting cardiac events in all diabetic patients.
Still, "one limitation of this study," the authors point out, "is lack of information on diabetic complications such as peripheral vascular disease, retinopathy, and neuropathy. It is not clear whether ischemia could remain predictive of events after controlling for these variables.
Previous reports have shown that dobutamine stress echocardiography is of prognostic value in diabetic patients, but most of the studies have focused on individuals with cardiac symptoms or a history of heart disease. Whether echocardiography-detected ischemia can predict cardiac events in diabetics with neither of these factors has not been studied.
As reported in the American Journal of Cardiology for May 1, Dr. Fabiola B. Sozzi, from Fondazione Ospedale Maggiore in Milan, Italy, and colleagues addressed this question in a study of 161 asymptomatic patients with type 2 diabetes who were followed for a median of five years.
Forty-five patients (28 per cent) had myocardial ischemia on dobutamine stress testing, the researchers report. During follow-up, 40 patients died (25 per cent), including 18 from cardiac causes, and seven patients had a nonfatal myocardial infarction.
Patients with myocardial ischemia on echocardiography were at increased risk for cardiac death and nonfatal myocardial infarction (p = 0.03). At five years, the rate of this composite outcome was 24 per cent with an abnormal exam result and 11 per cent with a normal result.
Coupled with prior results, the new findings suggest that dobutamine stress echocardiography is useful in predicting cardiac events in all diabetic patients.
Still, "one limitation of this study," the authors point out, "is lack of information on diabetic complications such as peripheral vascular disease, retinopathy, and neuropathy. It is not clear whether ischemia could remain predictive of events after controlling for these variables.
