| Prognostic value of dobutamine-atropine stress myocardial perfusion imaging in patients with diabetes. | |
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MedLine Citation:
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PMID: 12196440 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Exercise tolerance in patients with diabetes is frequently impaired due to noncardiac disease such as claudication and polyneuropathy. This study assesses the prognostic value of dobutamine stress myocardial perfusion imaging in patients with diabetes. RESEARCH DESIGN AND METHODS: A total of 207 consecutive diabetic patients who were unable to undergo exercise stress testing underwent dobutamine-atropine stress myocardial perfusion imaging. Follow-up was successful in 206 of 207 (99.5%) patients. A total of 12 patients underwent early (<60 days) revascularization and were excluded from the analysis. End points during follow-up were hard cardiac events, defined as cardiac death and nonfatal myocardial infarction. RESULTS: Abnormal myocardial perfusion was detected in 125 (64%) patients. During 4.1 +/- 2.4 years of follow-up, 73 (38%) deaths occurred, 36 (49%) of which were due to cardiac causes. Nonfatal myocardial infarction occurred in 7 (4%) patients, and 45 (23%) patients underwent late coronary revascularization. Cardiac death occurred in 2 of 69 (3%) patients with normal myocardial perfusion and in 34 of 125 (27%) patients with perfusion abnormalities (P < 0.0001). A multivariable Cox proportional hazard model demonstrated that, in addition to clinical and stress test data, an abnormal scan had an incremental prognostic value for prediction of cardiac death (hazard ratio 7.2, 95% CI 1.7-30). The summed stress score was an important predictor of cardiac death; the hazard ratio was 1.2 (95% CI 1.07-1.34) per one-unit increment. CONCLUSIONS: Dobutamine-atropine stress myocardial perfusion imaging provides additional prognostic information incremental to clinical data in patients with diabetes who are unable to undergo exercise stress testing. |
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Authors:
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Arend F L Schinkel; Abdou Elhendy; Ron T van Domburg; Jeroen J Bax; Eleni C Vourvouri; Fabiola B Sozzi; Roelf Valkema; Jos R T C Roelandt; Don Poldermans |
Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Diabetes care Volume: 25 ISSN: 0149-5992 ISO Abbreviation: Diabetes Care Publication Date: 2002 Sep |
Date Detail:
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Created Date: 2002-08-28 Completed Date: 2003-02-07 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7805975 Medline TA: Diabetes Care Country: United States |
Other Details:
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Languages: eng Pagination: 1637-43 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Atropine / diagnostic use Coronary Circulation Death, Sudden, Cardiac Diabetes Mellitus, Type 1 / diagnosis*, mortality Dobutamine / diagnostic use Exercise Test / methods* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / diagnosis, mortality Parasympatholytics / diagnostic use Predictive Value of Tests Prognosis Survival Analysis Sympathomimetics / diagnostic use |
| Chemical | |
Reg. No./Substance:
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0/Parasympatholytics; 0/Sympathomimetics; 34368-04-2/Dobutamine; 51-55-8/Atropine |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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