Prognostic value of dobutamine echocardiography in patients with intermediate coronary lesions at angiography.
The prognostic value of dobutamine echocardiography (DOBU-ECHO) in patients with intermediate coronary lesions has not been described in the literature. The aim of this study was to determine the prognostic value of DOBU-ECHO in patients presenting with coronary lesions smaller than 50% at angiography. Ninety-four consecutive patients were analyzed and followed-up for 64 +/- 7 months (range: 12 to 75 months). All patients presented with coronary lesions between >or= 30% and < 50% of the luminal diameter of at least one major epicardial vessel. The patient population was divided into two groups: Those with a positive DOBU-ECHO (n = 23) and those with a negative DOBU-ECHO (n = 71). The number of coronary lesions did not differ between the two groups. The patients with a positive DOBU-ECHO result were more likely than those in the negative group to have a family history of coronary artery disease or suffer from hypertension or a dyslipidemia. During the follow-up period, 13 cardiac events occurred (1 cardiac death, 5 myocardial infarctions, 2 unstable anginas, and 5 myocardial revascularizations), 11 (47.8%) of which occurred in patients with positive DOBU-ECHO. The annual incidence for a cardiac event was 7.9% per year in the positive DOBU-ECHO group and 0.5% per year in the negative DOBU-ECHO group (P < 0.001). This incidence remained significant for spontaneous cardiac events, such as cardiac death, myocardial infarction, and unstable angina (5.8% per year vs 0.2% per year; P < 0.001).


CONCLUSIONS
In patients with angiographically confirmed intermediate coronary lesions, a positive DOBU-ECHO is an additional risk factor for the onset of a cardiac event, whereas a negative DOBU-ECHO can be used to define patients with a low cardiac risk.
Ciaroni
Stefano
S
Medical/Surgical Cardiovascular Department, Hôpital de la Tour, Meyrin-Geneva, Switzerland.
Bloch
Antoine
A
Hoffmann
Jacques Lars
JL
Bettoni
Marco
M
Fournet
Dominique
D
D002316:Cardiotonic Agents; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000000981:diagnostic imaging*; D004280:Dobutamine; D025401:Echocardiography, Stress; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis
D002316:Cardiotonic Agents; D004280:Dobutamine