药物负荷超声心动图在已知或疑似冠状动脉疾病的糖尿病及非糖尿病患者中的预后价值  

Prognostic value of pharmacological stress echocardiography in diabetic and nondiabetic patients with known or suspected coronary artery disease

作　　者：Cortigiani L. Bigi R. Sicari R. 张宪伟 

机构地区：[1]Divisione di Cardiologia, Ospedale Campo diMarte, 55032 Lucca, Italy Dr.

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第6期59-60,共2页

摘　　要：OBJECTIVES: We sought to compare the prognostic value of pharmacological stress echocardiography(SE) in diabetic and nondiabetic patients with known or suspected coronary artery disease. BACKGROUND: Although SE is a useful tool for risk stratification of patients with diabetes, it has not been established whether it retains the same prognostic information in diabetic patients compared with nondiabetic patients. METHODS: A total of 5,456 patients(749 diabetics) undergoing dipyridamole(n=3,306) or dobutamine(n=2,150) SE were prospectively followed up for the occurrence of hard events(death and/or nonfatal myocardial infarction). RESULTS: During a median time of 31 months, 411 deaths and 236 infarctions occurred. There were 132 events in diabetic patients and 515 in nondiabetic patients(18% vs. 11% , respectively; p< 0.0001). Moreover, 1,607(29% ) patients underwent coronary revascularization and were censored. Ischemia at SE, resting wall motion score index, and age were independent predictors of death and hard events in both diabetic and nondiabetic patients. Compared with a normal test, ischemia and scar test patterns were associated to significantly lower age- corrected five- year hard event- free survival in diabetic as well as nondiabetic patients. However, a normal test was associated with a greater than two- fold annual event rate in diabetic patients as compared with nondiabetics who were either younger(2.6% vs. 1.0% ) or older(5.5% vs. 2.2% ) than 65 years of age. CONCLUSIONS: Stress echocardiographyis equally effective in risk stratifying diabetic and nondiabetic patients independently of age. However, the normal test result predicts a less favorable outcome in diabetic than in nondiabetic patients.OBJECTIVES： We sought to compare the prognostic value of pharmacological stress echocardiography （SE） in diabetic and nondiabetic patients with known or suspected coronary artery disease. BACKGROUND： Although SE is a useful tool for risk stratification of patients with diabetes, it has not been established whether it retains the same prognostic information in diabetic patients compared with nondiabetic patients. METHODS： A total of 5, 456 patients（749 diabetics） undergoing dipyridamole（n =3, 306） or dobutamine（n = 2, 150） SE were prospectively followed up for the occurrence of hard events（death and/or nonfatal myocardial infarction） . RESULTS： During a median time of 31 months, 411 deaths and 236 infarctions occurred. There were 132 events in diabetic patients and 515 in nondiabetic patients（18% vs. 11% , respectively; p 〈 0. 0001） . Moreover, 1, 607（29% ） patients underwent coronary revascularization and were censored. Ischemia at SE, resting wall motion score index, and age were independent predictors of death and hard events in both diabetic and nondiabetic patients. Compared with a normal test, ischemia and scar test patterns were associated to significandy lower age-corrected five-year hard event-free survival in diabetic as well as nondiabetic patients. However, a normal test was associated with a greater than two-fold annual event rate in diabetic patients as compared with non diabetics who were either younger（2.6% vs. 1.0% ） orolder（5.5% vs. 2.2% ） than 65 years of age.

关 键 词：药物负荷超声心动图 糖尿病患者 冠状动脉疾病 预后价值 疑似 致死性心肌梗死 冠状动脉血运重建 独立预测因素 随访期间 心肌缺血 

分 类 号：R542.2[医药卫生—心血管疾病] R587.1[医药卫生—内科学]