Stressechocardiography for risk stratification of asymptomatic patients with type 2 diabetes mellitus

Abstract

Background The purpose of this study was to assess stressechocardiography (SE) for risk stratification of asymptomatic type 2 diabetic patients (DM2) without known coronary artery disease CAD. Methods A total of 211 consecutive, asymptomatic DM2 patients underwent exercise ( n = 177) or dobutamine ( n = 34) SE and were followed up for 11 ± 2 months. Primary endpoint was a major cardiac or vascular event (MACCE; all-cause-death, non-fatal myocardial infarction, coronary revascularization procedures, cerebrovascular event, acute limb-ischemia). Results During follow-up 39 of these patients suffered a MACCE. SE correctly identified 33 of these 39 patients by demonstrating silent ischemia in advance. In a multivariate logistic regression analysis a positive SE turned out to be an independent predictor for the occurrence of a MACCE during 11 ± 2 months. Conclusions SE represents an effective tool for risk stratification of asymptomatic DM2 patients.