Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Clinical Investigation
Effects of Gender on Prognosis of Patients With Known or Suspected Coronary Artery Disease Undergoing Contrast-Enhanced Dobutamine Stress Echocardiography
Ryotaro WakeMasaaki TakeuchiJunichi YoshikawaMinoru Yoshiyama
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2007 Volume 71 Issue 7 Pages 1060-1066

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Abstract

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. Methods and 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. (Circ J 2007; 71: 1060 - 1066)

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© 2007 THE JAPANESE CIRCULATION SOCIETY
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