title: Assessment of dipyridamole stress echocardiography for risk stratification of diabetic patients.
abstract: BACKGROUND
  Despite advances in medical therapy, cardiovascular disease, mainly coronary artery disease (CAD), remains the leading cause of mortality among patients with diabetes mellitus (DM). The objective of the present study was to assess the effectiveness of dipyridamole stress echocardiography in identify diabetic patients at high risk for cardiovascular events.
  
  
  METHODS
  Dipyridamole stress echocardiography was administered to 483 diabetic patients (294 women; mean age 63.41 ± 11.28 years) between July 2006 and December 2012.
  
  
  RESULTS
  Follow-up data were available for 264 patients (163 women; mean age 64.3 ± 10.5 years): 250 with a negative stress echocardiography and 14 with a positive stress echo. During a mean follow-up time of 18 ± 14 months, a cardiovascular event occurred in 18 (6.8%) patients, 12 (4.8%) in patients with a negative stress echo (n = 250) during a mean follow-up period of 20 ± 16 months and 6 (42%) in patients with positive stress echo (n = 14) during a mean follow-up of 13 ± 13 months. The positive and negative predictive values of stress echocardiography were 42% and 96% respectively. The accuracy value was 92%. A Cox regression model showed that CAD (hazard ratio [HR] 5.4, 95% confidence interval [CI] 1.9-15.4; p = 0.002) and positive stress echocardiography (HR 7.1, 95% CI 2.5-20.5; p < 0.001) were significant predictors of cardiovascular events.
  
  
  CONCLUSIONS
  For patients with diabetes, a negative dipyridamole stress echocardiogram predicts favorable outcome during the first year of follow-up. A new stress imaging test should be done after 12 months in diabetic patients.
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901, Curitiba, Paraná, Brazil. lizandreabaroncini@hotmail.com.
authors.forename: Liz Andréa Villela
authors.initials: LAV
authors.lastname: Baroncini
authors.affiliation: Department of Internal Medicine, Medical School, Universidade Federal do Paraná, Rua XV de Novembro, 1299, Centro, CEP: 80060-000, Curitiba, Paraná, Brazil.
authors.forename: Rafael
authors.initials: R
authors.lastname: Borsoi
authors.affiliation: Medical School, Faculdade Evangélica, Rua Padre Anchieta, 2770, CEP: 80730-000, Curitiba, Paraná, Brazil.
authors.forename: Maria Eugênia Bégué
authors.initials: MEB
authors.lastname: Vidal
authors.affiliation: Medical School, Faculdade Evangélica, Rua Padre Anchieta, 2770, CEP: 80730-000, Curitiba, Paraná, Brazil.
authors.forename: Nathália Julim
authors.initials: NJ
authors.lastname: Valente
authors.affiliation: Pontificia Universidade Católica do Paraná, Curitiba, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Veloso
authors.affiliation: Center of Health and Biological Sciences, Pontificia Universidade Católica do Paraná, Rua Imaculada Conceição, 1155, Prado Velho, CEP: 80215-901, Curitiba, Paraná, Brazil.
authors.forename: Roberto
authors.initials: R
authors.lastname: Pecoits Filho
mesh_terms: D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000401:mortality*; D048909:Diabetes Complications / Q000000981:diagnostic imaging* / Q000401:mortality*; D004176:Dipyridamole; D025401:Echocardiography, Stress / Q000706:statistics & numerical data*; D005080:Exercise Test; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D004176:Dipyridamole