Effects of gender on prognosis of patients with known or suspected coronary artery disease undergoing contrast-enhanced dobutamine stress echocardiography.
BACKGROUND
Gender differences in the predictors of outcome among patients with known or suspected coronary artery disease (CAD) undergoing contrast-enhanced dobutamine stress echocardiography (CE-DSE) have not been completely determined.


RESULTS
Follow-up (30+/-17 months) data for 581 men and 309 women with known or suspected CAD who underwent CE-DSE (mean age: 66 years) were obtained. Hard cardiac events included cardiac death and nonfatal myocardial infarction. Total cardiac events included hard cardiac events, unstable angina, congestive heart failure, and late revascularization (>3 months). Cardiac events occurred in 123 male and 50 female patients. Positive results for CE-DSE were associated with worse prognosis in both men and women (2-year total event free rate: 73.5% vs 88.2% in men, p<0.0001, 80.3% vs 91.3% in women, p<0.01). Addition of CE-DSE results, including abnormal left ventricular end-systolic volume response and left ventricular ejection fraction at peak stress <50%, to the clinical and rest echocardiography model provided incremental information for predicting total cardiac events (increase in chi-square value for the model from 60 to 72, p<0.001) in men and (increase in chi-square value for the model from 17 to 32, p<0.001) in women.


CONCLUSIONS
CE-DSE provides incremental information for predicting future cardiac events in both men and women.
Wake
Ryotaro
R
Department of Cardiology and Internal Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan. waker@med.osaka-cu.ac.jp
Takeuchi
Masaaki
M
Yoshikawa
Junichi
J
Yoshiyama
Minoru
M
D000368:Aged; D000789:Angina, Unstable / Q000209:etiology; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology; D025401:Echocardiography, Stress; D005260:Female; D005500:Follow-Up Studies; D005783:Gender Identity; D006333:Heart Failure / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology